Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"Correction to: \"Inflammation and Prediction of Death in Type 2 Diabetes. Evidence of an Intertwined Link With Tryptophan Metabolism\".","authors":"","doi":"10.1210/clinem/dgaf119","DOIUrl":"https://doi.org/10.1210/clinem/dgaf119","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: \"Long-Acting Growth Hormone Therapy in Pediatric Growth Hormone Deficiency: A Consensus Statement\".","authors":"","doi":"10.1210/clinem/dgaf125","DOIUrl":"https://doi.org/10.1210/clinem/dgaf125","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Parathyroid Hormone Across the Spectrum of Renin-Independent Aldosteronism.","authors":"Angeline Ooi, Hakim Khan, Muhammad Akram, Peter J Fuller, Frances Milat, Jun Yang, Renata Libianto","doi":"10.1210/clinem/dgaf151","DOIUrl":"https://doi.org/10.1210/clinem/dgaf151","url":null,"abstract":"<p><strong>Context: </strong>Primary aldosteronism (PA) is the most common cause of endocrine hypertension. While elevated serum parathyroid hormone (PTH) levels have been associated with PA, the extent and nature of this relationship across the broader spectrum of renin-independent aldosteronism remain unclear.</p><p><strong>Objective: </strong>This study aims to elucidate the relationship between PTH and aldosterone excess across the spectrum of renin-independent aldosteronism.</p><p><strong>Design, setting, participants: </strong>Adults screened for PA who also had a PTH measurement were retrospectively identified from the Monash Health Endocrine Hypertension Clinic (N=462). Based on the aldosterone-to-renin ratio, and results of the saline suppression test where applicable, patients were categorized into three groups: PA, \"low renin without PA\" and non-PA. The association between PTH and PA status was evaluated.</p><p><strong>Main outcome measures: </strong>Serum PTH concentration.</p><p><strong>Results: </strong>PTH levels were higher in patients with PA compared to \"low renin without PA\" and non-PA (median 5.7 vs 5.3 vs 5.1 pmol/L respectively, p<.05) despite comparable calcium and kidney function. 24-hour urinary calcium excretion increased progressively across the spectrum of renin suppression (4.1 vs 4.3 vs 4.9 mmol/day in non-PA, \"low renin without PA\" and PA groups respectively, p<.05). Patients with PA were more likely to have elevated PTH with normal serum calcium concentration compared to those without PA (38% vs 28%, p=.010).</p><p><strong>Conclusions: </strong>Increasing PTH concentration and 24-hour urinary calcium excretion were observed across the spectrum of renin-independent aldosteronism. While PTH remained in the normal range for most patients, PA may be considered in patients with elevated PTH and normal serum calcium concentration.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Insulin Work as Good One or Bad One for the Cardiovascular Tissues?","authors":"Yoshihiko Nishio","doi":"10.1210/clinem/dgaf051","DOIUrl":"https://doi.org/10.1210/clinem/dgaf051","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Menopause has a beneficial influence on the evolution of prolactinomas. A study of 99 patients.","authors":"Stefan Matei Constantinescu, Caterina Maria Nava, Fanny Chasseloup, Orsalia Alexopoulou, Philippe Chanson, Dominique Maiter","doi":"10.1210/clinem/dgaf152","DOIUrl":"https://doi.org/10.1210/clinem/dgaf152","url":null,"abstract":"<p><strong>Context: </strong>Menopause is thought to have beneficial effects in women with prolactinoma, potentially offering a higher chance for successful dopamine agonist (DA) withdrawal. However, strong evidence supporting this remains limited.</p><p><strong>Objective: </strong>To assess the impact of menopause on prolactinoma evolution and recurrence after DA withdrawal.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Two tertiary academic hospitals.</p><p><strong>Patients: </strong>We retrospectively analysed data from 99 women undergoing menopause (Mp, defined as 12 months of amenorrhea, low estradiol and FSH>25 U/L) while still on DA treatment for a prolactinoma (mean age at diagnosis: 37.9 ± 8.1 years). The tumors were microadenomas in 67 cases and macroadenomas in 32 (12 invasive).</p><p><strong>Results: </strong>In post-menopausal women continuing DA at stable doses, median prolactin (PRL) levels decreased significantly from 18.0 µg/L before Mp to 9.8 µg/L 3-6 months after Mp (n=71, p=0.05) and to 7.9 µg/L after 24 months (n=45, p<0.001). Coronal surface also decreased significantly from 16.5 to 8.2 mm² at 24 months (n=34, p<0.01). DA treatment was successfully discontinued in 56 women, all meeting stringent criteria for discontinuation, with 41 (73%) remaining in remission over a median follow-up of 29 months. Recurrence occurred in 15 women (27%), mostly within the first year post-DA withdrawal. PRL concentration measured 3-6 months after DA discontinuation was the only independent predictor of recurrence. Estrogen-progestin replacement therapy, given in 23 women, did not influence prolactinoma outcome.</p><p><strong>Conclusions: </strong>We confirm that menopause has a beneficial effect on the evolution of prolactinomas. When fulfilling stringent criteria for DA withdrawal, two-thirds of post-menopausal women can expect sustained remission, and recurrences are generally mild and asymptomatic.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of Leydig cell dysfunction in previous illicit androgen users.","authors":"Yeliz Bulut, Niels Brandt-Jacobsen, Rasmus Madsen, Mario Thevis, Jan Frystyk, Jakob Albrethsen, Niels Jørgensen, Anders Juul, Caroline Kistorp, Jon Jarløv Rasmussen","doi":"10.1210/clinem/dgaf157","DOIUrl":"https://doi.org/10.1210/clinem/dgaf157","url":null,"abstract":"<p><strong>Background and objectives: </strong>A few studies have explored the impairment of pituitary gonadotroph and Leydig cell function in men who recently ceased illicit androgen use, as assessed by stimulation tests. However, the capacity of the pituitary-testis axis in previous users who discontinued androgen use years ago remains unclear. This study evaluated the pituitary-testis-axis capacity in previous illicit androgen users and nonusers.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of recreational strength training men with (n=30) and without (n=26) a history of illicit androgen use. Previous users were subdivided into two subgroups based on detectable (Group 1, n=17) and undetectable (Group 2, n=13) performance-enhancing drugs in the urine.We performed gonadotropin-releasing hormone and hCG stimulation tests. Serum LH was measured with immunoassay, total testosterone and insulin-like factor 3 with LC-MS/MS. Sexual function was assessed using the IIEF-15 questionnaire.</p><p><strong>Results: </strong>Elapsed duration since androgen cessation, geometric mean (95%CI), was 1.9(1.2;3.0) years in previous androgen users. Mean (SD) age of all participants was 33 (8) years.Testosterone secretion after hCG injection was lower in previous users than nonusers: Group 1 difference, -6.4(-11.3; -1.5) nmol/L, (P=0.031); Group 2 difference, -14.2(-19.5; -8.8) nmol/L, (P<0.001). LH secretion did not differ between the groups.Multivariate linear regressions using erectile function as dependent variable, revealed that higher testosterone secretion during the hCG test (P=0.046) was independently associated with better erectile function, whereas baseline serum testosterone (P=0.780) and estradiol (P=0.405) were not.</p><p><strong>Conclusions: </strong>Previous illicit androgen users exhibited decreased Leydig cell capacity two years after androgen cessation which potentially influence erectile function.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach to the patient: Low testosterone concentrations in men with obesity.","authors":"Christopher A Muir, Gary A Wittert, David J Handelsman","doi":"10.1210/clinem/dgaf137","DOIUrl":"https://doi.org/10.1210/clinem/dgaf137","url":null,"abstract":"<p><p>Pathologic hypogonadism occurs when serum testosterone is significantly and persistently reduced by irreversible organic (structural, genetic) disorders of the hypothalamic pituitary testicular (HPT) axis. Men with pathologic hypogonadism require life-long testosterone replacement. In contrast, mild or moderate reductions in serum testosterone frequently accompany obesity and its numerous co-morbidities in men and are best considered as non-gonadal illness syndromes, wherein reduction in serum testosterone is usually reversible upon amelioration of the underlying non-gonadal illness. Obesity can result in non-specific symptoms in conjunction with reduced serum testosterone and serum SHBG. Obesity-related reductions in SHBG, testosterone's principal circulating carrier protein, are primarily responsible for measured reductions in testosterone. However, obesity is not a cause of pathological hypogonadism and proportionately reduced testosterone and SHBG concentrations accompanied by normal serum LH and FSH concentrations confirm a eugonadal state, best described as the pseudo-hypogonadism of obesity. Herein we demonstrate how clinically significant weight loss substantially reverses obesity-related reductions in serum testosterone and ameliorates non-specific symptoms resembling, but not due to, androgen deficiency. The important reversible steps include weight reduction, optimizing management of type 2 diabetes mellitus, obstructive sleep apnea, depression and other obesity related co-morbidities as well as rationalizing concomitant drug regimens. In the absence of pathological hypogonadism, testosterone treatment is less effective than a diet and lifestyle intervention to rectify the reversible conditions responsible for the non-specific symptoms and associated reduced serum testosterone concentrations observed in men with obesity. As such, testosterone treatment is not indicated and unwarranted off-label testosterone treatment can lead to adverse effects such as infertility, elevated hematocrit requiring venesection, a prothrombotic state and testosterone dependence.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study.","authors":"Marta Araujo-Castro, Aura Herrera, Yanbo Wang, Zhicheng Wang, Maciej Śledziński, Andrzej Hellmann, Marco Raffaelli, Francesco Pennestrì, Mark Sywak, Alexander J Papachristos, Fausto F Palazzo, Tae-Yon Sung, Byung-Chang Kim, Yu-Mi Lee, Fiona Eatock, Hannah Anderson, Maurizio Iacobone, Albertas Daukša, Ozer Makay, Yigit Turk, Hafize Basut Atalay, Els J M Nieveen van Dijkum, Anton F Engelsman, Isabelle Holscher, Gabriele Materazzi, Leonardo Rossi, Chiara Becucci, Susannah L Shore, Clare Fung, Alison Waghorn, Radu Mihai, Sabapathy P Balasubramanian, Arslan Pannu, Shuichi Tatarano, David Velázquez-Fernández, Julie A Miller, Hazel Serrao-Brown, Yufei Chen, Marco Stefano Demarchi, Reza Djafarrian, Helen Doran, Kelvin Wang, Michael J Stechman, Helen Perry, Johnathan Hubbard, Cristina Lamas, Philippa Mercer, Janet MacPherson, Supanut Lumbiganon, María Calatayud, Felicia Alexandra Hanzu, Oscar Vidal, Cesar Minguez Ojeda, Theodosios Papavramidis, Pablo Rodríguez de Vera Gómez, Abdulaziz Aldrees, Tariq Altwjry, Nuria Valdés, Cristina Álvarez-Escola, Iñigo García Sanz, Concepción Blanco Carrera, Laura Manjón-Miguélez, Paz De Miguel Novoa, Mónica Recasens, Rogelio García Centeno, Cristina Robles Lázaro, Klaas Van Den Heede, Sam Van Slycke, Theodora Michalopoulou, Sebastian Aspinall, Ross Melvin, Joel Wen Liang Lau, Wei Keat Cheah, Man Hon Tang, Han Boon Oh, John Ayuk, Kevin Verhoeff, Robert P Sutcliffe, Alessandro Parente","doi":"10.1210/clinem/dgaf154","DOIUrl":"https://doi.org/10.1210/clinem/dgaf154","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative outcomes of patients with normotensive pheochromocytomas are poorly documented. We aimed to evaluate the impact of preoperative hypertension on post-operative outcomes following adrenalectomy for pheochromocytoma.</p><p><strong>Methods: </strong>An international retrospective study of patients undergoing adrenalectomy for pheochromocytoma in 46 centers between 2012-2022 was performed. Hypertensive and normotensive pheochromocytoma were defined respectively by the presence or absence of hypertension history before or at the time of pheochromocytoma diagnosis. To evaluate differences in postoperative outcomes between hypertensive and normotensive patients, propensity score matched (PSM) analysis was performed.</p><p><strong>Results: </strong>Among 2,016 patients with pheochromocytoma, 1,034 (51.2%) had preoperative hypertension and 982 (49.8%) were normotensive. Hypertensive patients were 4.5 years older (p<0.001), had higher prevalence of type 2 diabetes (p<0.001), had a higher median Charlson Comorbidity Index (2.0 vs. 1.0; p<0.001) and had an ASA III-IV more frequently (41% vs. 19.9%, p<0.001) than normotensive patients. Non-adjusted analysis demonstrated that hypertensive patients had longer operative time (115.0 vs. 103.5 minutes; p=0.026), higher rate of vasopressors at skin closure (19.7% vs 15.4%; p=0.013), more perioperative blood transfusions (7.7% vs. 5.0%; p=0.016) and increased complication rate (21.6% vs. 17.7%; p=0.029). However, after 1:1 PSM, we found that readmission, complications, and serious complications were similar between cohorts.</p><p><strong>Conclusions: </strong>Patients with hypertensive pheochromocytomas have a higher risk of postoperative complications than normotensive cases due to the association of hypertension with a higher burden of comorbidities and older age. However, hypertension is not an independent risk factor of postoperative complications after pheochromocytoma surgery.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Letter to the Editor from Candemir and Çakal: [24-hour Urine Calcium Predicts Reduced Fracture Incidence and Improved Bone Mineral Density After Surgery for Primary Hyperparathyroidism]\".","authors":"Burcu Candemir, Erman Çakal","doi":"10.1210/clinem/dgaf126","DOIUrl":"https://doi.org/10.1210/clinem/dgaf126","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"Letter to the Editor from Candemir and Çakal: [24-hour Urine Calcium Predicts Reduced Fracture Incidence and Improved Bone Mineral Density After Surgery for Primary Hyperparathyroidism]\".","authors":"Martin Nilsson, Kristina E Åkesson, Mark Thier, Erik Nordenström, Martin Almquist, Anders Bergenfelz","doi":"10.1210/clinem/dgaf127","DOIUrl":"https://doi.org/10.1210/clinem/dgaf127","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}