Endocrine最新文献

{"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":"https://doi.org/10.1007/s12020-025-04232-9","url":null,"abstract":"<p><strong>Purpose: </strong>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 <sup>131</sup>I and combining them with the results of follow-up assessment using Dynamic Risk Stratification (DRS).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 < 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%.</p><p><strong>Conclusion: </strong>For patients with PTC who received <sup>131</sup>I therapy after surgery and are classified as BIR, <sup>131</sup>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 <sup>131</sup>I retreatment. The Ps-Tg and first sup-Tg values after the f","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-20","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":"Bone evaluation and relationship between body composition and bone mass in anorexia nervosa followed up by a multidisciplinary team.","authors":"Iana Mizumukai de Araújo, Maria Victoria Figueiredo Rebolho, Mayra Macena Gomes, Vivian Marques Suen, Francisco José Albuquerque de Paula","doi":"10.1007/s12020-025-04231-w","DOIUrl":"https://doi.org/10.1007/s12020-025-04231-w","url":null,"abstract":"<p><strong>Purpose: </strong>Anorexia nervosa is a psychiatric disorder characterized by self-imposed fasting and significant weight loss, leading to nutrient deficiencies that disrupt bone metabolism. This cross-sectional observational study aimed to characterize the bone health of women with anorexia nervosa using dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and 3D shaper analysis.</p><p><strong>Methods: </strong>The study involved 12 women diagnosed with anorexia nervosa monitored by a multidisciplinary team and 11 control subjects. Both groups underwent blood sampling and assessments with DXA, TBS, and 3D shaper analysis.</p><p><strong>Results: </strong>The results indicated that areal bone mineral density (aBMD) and Z-scores at the total hip and femoral neck were significantly lower in the anorexia group compared to controls (p < 0.05). Additionally, the fat mass index was reduced in women with anorexia (p < 0.05). Appendicular lean mass index (ALMI) was similar between the two groups. 3D shaper analysis revealed that surface BMD (sBMD), volumetric BMD (vBMD), integral vBMD, and trabecular vBMD were generally lower in the anorexia group. Associations were found between proximal femur 3D parameters and total hip and femoral neck aBMD. Moreover, significant correlations were observed between total cortical vBMD, total cortical sBMD, integral vBMD, and TBS. ALMI was associated with total cortical thickness and showed a trend toward association with femoral neck Z-score.</p><p><strong>Conclusion: </strong>In addition to previous studies indicating bone impairment in AN using DXA and TBS, the present study suggests that the 3D Shaper is also capable of detecting bone loss in this disorder. Therefore, the data encourage the further studies to assess the role of the 3D Shaper in prediction of fracture.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023911","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":"Liquid formulations of Levothyroxine with ethanol or with parabens for treatment of congenital hypothyroidism: similar TSH and fT4 values in the first 6 months of follow up.","authors":"Gaia Vincenzi, Giulia Tarantola, Stefano Mora, Marco Abbate, Cristina Santagiuliana, Ilenia Teresa Petralia, Luisa Del Giacco, Sara Zanelli, Graziano Barera, Maria Cristina Vigone","doi":"10.1007/s12020-025-04230-x","DOIUrl":"https://doi.org/10.1007/s12020-025-04230-x","url":null,"abstract":"<p><strong>Purpose: </strong>Two liquid formulations of Levothyroxine (L-T4) are available in Italy: one containing ethanol and one containing parabens. In the literature, few data demonstrate efficacy of the ethanol-free formulation. Our study aims at comparing the efficacy of these formulations in the first six months of treatment in newborns affected by congenital hypothyroidism (CH).</p><p><strong>Methods: </strong>236 children diagnosed with CH in our centre between 2011 and 2022 were enrolled according to the L-T4 formulation used: ethanol-containing (group A) or parabens-containing (group B). We collected data at diagnosis (gestational age, TSH, fT4, daily dose/kg, aetiology), at 7-15 days, 1 month, 3 months, and 6 months after diagnosis (TSH, fT4, daily dose/kg).</p><p><strong>Results: </strong>164 patients were enrolled in group A and 72 in group B. TSH was lower in group B compared to group A at diagnosis. fT4 was significantly higher in group B at 1 and 3 months, but always in the correct range for age. L-T4 dosage was lower in group B than in group A at 7-15 days, 1 month, and 6 months after diagnosis. Since more patients had gland in situ in group B than in group A (75 vs 57%), we repeated the previous analyses in this subgroup of patients, confirming the results. In both subgroups, the percentages of patients with TSH and fT4 concentrations within normal range during follow-up were not significantly different.</p><p><strong>Conclusion: </strong>Our study confirms the efficacy of both therapeutic strategies in the treatment of CH, allowing to individualize therapy depending on the needs of each patient.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040363","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":"Obesity and blunted FGF23 response associate with kidney impairment in patients with hypoparathyroidism.","authors":"Luigi di Filippo, Agnese Allora, Anna Maria Formenti, Francesca Ferrari, Marta Villanova, Antonino Russo, Barbara Presciuttini, Massimo Locatelli, Maria Luisa Brandi, Giuseppe Vezzoli, Claudio Marelli, Andrea Giustina","doi":"10.1007/s12020-025-04221-y","DOIUrl":"https://doi.org/10.1007/s12020-025-04221-y","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic kidney disease (CKD) is a common complication of patients affected by chronic hypoparathyroidism managed with conventional therapies. However, no data are currently available regarding the endocrine and metabolic determinants of renal function in these patients.</p><p><strong>Methods: </strong>This was a multicenter observational study performed in three health-care centres. Patients with hypoparathyroidism were consecutively enrolled during follow-up visits in 2022-2023. These exclusion criteria were adopted: patients managed with dialysis, proteinuria (>200 mg/24 h), use of antihypertensive drugs including thiazides, ACE-inhibitors, angiotensin-II-receptor antagonists, alpha-beta blocking-agents, aldosterone-antagonists, and insulin-treated diabetes.</p><p><strong>Results: </strong>A total of 46 patients were enrolled. Median age was 53 years, 34 (74%) were female and the median disease duration was 11 years. In all patients, the calcium-phosphate product was within the normal range. The 23.7% of patients was obese (BMI ≥ 30) and CKD (defined with an eGFR < 60 mL/min1.73m²) was found in the 21.7% of patients. Patients with CKD were older, affected by a longer-disease, more frequently obese and with higher BMI. In multivariate analyses, obesity resulted as the only significant independent risk factor associated with CKD. In addition, a significant negative correlation was found between BMI and eGFR, and ROC analyses showed a significant global-performances of BMI to predict CKD. Patients with CKD were characterized also by higher FGF23 levels. A significant negative correlation was found between FGF23 and eGFR, however, evaluating separately those with and without CKD, this correlation remained significant only in the second group.</p><p><strong>Conclusions: </strong>For the first-time, obesity was demonstrated to be independently associated with CKD in patients with hypoparathyroidism, and a blunted eGFR-related response of FGF23 was shown in patients with CKD potentially worsening the renal function in the context of hypoparathyroidism.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055372","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":"Lipoprotein profile as a predictor of type 2 diabetes with sarcopenia: a cross-sectional study.","authors":"Ting Tang, Junjie Hao, Qingyan Yang, Guodan Bao, Zhong-Ping Wang","doi":"10.1007/s12020-025-04226-7","DOIUrl":"https://doi.org/10.1007/s12020-025-04226-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the relationship between lipoprotein profiles and sarcopenia in patients with type 2 diabetes mellitus (T2DM). The objective is to provide a solid theoretical foundation and treatment strategies for clinical prevention and management of diabetes, particularly in individuals with concurrent sarcopenia.</p><p><strong>Methods: </strong>In this study, we selected inpatients aged over 60 years diagnosed with T2DM who were admitted to the Department of Geriatrics at Qinghai University Affiliated Hospital from July 2023 to June 2024 as research subjects. We collected general patient data, including gender, age, ethnicity, height, weight, and calculated body mass index (BMI). Key indices measured included glycated hemoglobin (HbA1c), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoproteins A and B (ApoA and ApoB), phospholipids, lipoprotein(a) [Lp(a)], very low-density lipoprotein (VLDL), and free fatty acids (FFA). Additionally, we assessed limb skeletal muscle mass, grip strength, walking speed, and calculated the appendicular skeletal muscle mass index (ASMI). Based on Asian diagnostic criteria for sarcopenia, patients were categorized into a non-sarcopenic group or a group with T2DM combined with sarcopenia. Baseline laboratory data along with ASMI measurements, grip strength assessments, and walking speeds were statistically analyzed for both groups.</p><p><strong>Results: </strong>Compared with T2DM patients without sarcopenia, the levels of HbA1c, Lp(a), FFA, serum albumin, TC, TG, HDL-C, ApoA and VLDL in type 2 diabetic patients with sarcopenia were statistically significant (all P < 0.05). When multivariate adjustments were made for these clinical features, age (OR = 1.18, 95%CI: 1.11-1.25, P < 0.001), BMI (OR = 0.81, 95%CI: 0.72-0.92, P < 0.001), ApoA (OR = 0.03, 95%CI: 0.00-0.90, P = 0.043), Lp(a) > = 15.5 mg/dL (OR = 3.14, 95%CI: 1.51-6.54, P = 0.002) and FFA > = 0.48 g/L (OR = 4.11, 95%CI: 1.97-8.57, P < 0.001) were independent predictors of diabetes mellitus with sarcopenia. ROC curve analysis showed that free fatty acids (AUC = 0.721, 95%CI: 0.660-0.782, P < 0.001) in T2DM with sarcopenia has good predictive value judgment.</p><p><strong>Conclusion: </strong>Age, BMI, ApoA, Lp(a), and FFA were independent predictors of T2DM with sarcopenia. Serum free fatty acids have a good predictive value in the judgment of T2DM complicated with sarcopenia.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023913","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":"Recovery of pituitary function in patients with apoplexy immediately after surgical resection of necrotic tumors.","authors":"R Kortbawi, A Ray, W R Selman, B M Arafah","doi":"10.1007/s12020-025-04222-x","DOIUrl":"https://doi.org/10.1007/s12020-025-04222-x","url":null,"abstract":"<p><strong>Background: </strong>Pituitary tumor apoplexy [PTA] and Rathke's Cleft Cyst apoplexy (RCCA) are uncommon disorders causing hypopituitarism.</p><p><strong>Objective: </strong>Examine the value of perioperative hormonal alterations in predicting recovery of impaired function in patients with PTA and RCCA.</p><p><strong>Methods: </strong>Consecutive PTA (N = 97) and RCCA (N = 41) patients who had emergent surgery received dexamethasone until surgery. Perioperative HPA function and prolactin levels were frequently assessed while hydrocortisone therapy was provided to those exhibiting clinical or biochemical evidence [cortisol <10 ug/dL; <276 nmol/L] for insufficiency. Patients with multiple perioperative cortisol levels ≥15 ug/dL [414 nmol/L] were considered to have normal postoperative HPA function.</p><p><strong>Results: </strong>Patients with PTA were more likely to be males, older, have more severe hormonal deficits and worse visual impairment than those with RCCA. Impaired HPA function and lower prolactin levels were more prevalent in patients with PTA than in those with RCCA. Perioperative recovery of HPA function was demonstrated by a brisk increase in ACTH followed by a rise in two ACTH-dependent adrenal steroids: cortisol and DHEA-S in 23/59 [39%] patients with PTA and in 16/20 [80%] others with RCCA. The perioperative rise in ACTH was mirrored by a decline in prolactin levels. Patients recovering function had higher [P < 0.01] preoperative prolactin levels than those with persistent deficit. Follow up HPA testing confirmed perioperative assessment.</p><p><strong>Conclusions: </strong>Perioperative measurements of ACTH and its dependent adrenal steroid levels accurately predict recovery of HPA function and support previously postulated role of increased intrasellar pressure and stalk compression in the pathogenesis of hypopituitarism in this setting.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003020","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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-12","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":"Predictors of response to lenvatinib in advanced differentiated thyroid cancer: focus on the CONUT score.","authors":"Edoardo Talpacci, Silvia Morelli, Vincenzo Leone, Sonia Moretti, Miriam Paci, Vittorio Bini, Efisio Puxeddu","doi":"10.1007/s12020-025-04228-5","DOIUrl":"https://doi.org/10.1007/s12020-025-04228-5","url":null,"abstract":"<p><strong>Objective: </strong>Lenvatinib is a multityrosine kinase inhibitor approved for progressive radioiodine refractory differentiated thyroid cancer (RAI-R-DTC). Despite its efficacy, most of the initial experiences showed global inferior results if compared with SELECT study. Baseline disease stages, previous systemic treatments and baseline patients' characteristics may affect response to therapy. The aim of our study was to review relevant clinical outcomes, identifying survival predictors, of a single center cohort of patients with advanced thyroid cancer treated with Lenvatinib.</p><p><strong>Methods: </strong>Twenty-two patients with progressive RAIR-R-DTC treated with Lenvatinib were retrospectively included. For each patient, we reviewed the main clinical baseline characteristics, including nutritional status. We evaluated the latter by using CONtrolling NUTritional status (CONUT) score. Clinical outcomes were overall survival (OS) and progression free survival (PFS).</p><p><strong>Results: </strong>At the time of analysis, 14 patients (63.6%) were alive with a median OS of 54 months (95% CI 20.35-87.65 months). Progression occurred in 16 patients (72.7%) with a median PFS of 21 months (95% CI 0-47.33 months). Nineteen out of 22 patients (86.4%) presented at least one adverse event (AE) of any grade. Baseline lower CONUT score significantly correlated with both longer PFS (HR 2.77- 95% CI 1.216-6.307, p = 0.015) and longer OS (HR 4.455-95% CI 1.211-16.391, p = 0.025). A significant longer survival was observed in patients with ECOG 0 compared to those with ECOG 1 and in the latter compared to ECOG 2 group (Log-rank test: p = 0.040). Conversely, higher baseline ECOG Performance Status (PS) correlated with higher severity of AEs (rs 0.468, p = 0.027). Finally, responder patients showed a significantly better PFS (HR 2.337-95% CI 1.091-5.006, p = 0.029).</p><p><strong>Conclusion: </strong>We confirmed the good efficacy of Lenvatinib treatment in progressive advanced RAI-R-DTCs showing the prognostic value of best tumor response, ECOG PS and CONUT score.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051776","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 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":"https://doi.org/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":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-09","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":"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":"https://doi.org/10.1007/s12020-025-04224-9","url":null,"abstract":"","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-04-09","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}