Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"Bone Material Strength Index Is Low in Patients With Cushing's Syndrome Even After Long-term Remission.","authors":"Manuela Schoeb, Paula J C Sintenie, Leontine E H Bakker, Nienke R Biermasz, Femke M van Haalen, Michiel F Nijhoff, Friso de Vries, Elizabeth M Winter, Alberto M Pereira, Natasha M Appelman-Dijkstra","doi":"10.1210/clinem/dgae799","DOIUrl":"10.1210/clinem/dgae799","url":null,"abstract":"<p><strong>Objective: </strong>Hypercortisolism in endogenous Cushing's syndrome (CS) results in decreased bone mineral density (BMD) and increased fracture risk. Although after remission BMD improves, the fracture rate remains elevated, suggesting that BMD may not adequately reflect fracture risk in this group. The aim was to evaluate bone material properties, another component of bone quality, using impact microindentation in patients with CS in remission.</p><p><strong>Methods: </strong>Cross-sectional study in 60 CS patients and 60 age-, sex-, and BMD-matched controls at a tertiary referral center between 2019 and 2021. Bone material strength index (BMSi) was measured by impact microindentation using the OsteoProbe® device at the tibia. In addition, laboratory investigation, BMD, and vertebral fracture assessment were performed.</p><p><strong>Results: </strong>By design, patients and controls were comparable for age (median age 56.5 years), sex (48 women), and BMD at the lumbar spine and femoral neck. They were also comparable regarding the number of fragility fractures (21 vs 27, P = .22). The median time of remission in patients was 6 years (range 1 to 41). Despite comparable BMD, BMSi was significantly lower in CS patients compared to controls (76.2 ± 6.7 vs 80.5 ± 4.9, P < .001). In CS patients, BMSi was negatively correlated with body mass index (r = -0.354, P = .01) but not related to the presence of fracture, physiological hydrocortisone replacement use, other pituitary insufficiencies, or time since remission.</p><p><strong>Conclusion: </strong>Bone material properties remain altered in patients with endogenous CS, even after long-term remission. These abnormalities, known to be associated with fractures in other populations, may play a role in the persistent bone fragility of steroid excess.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2691-e2699"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676517","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":"Effect of Methimazole Withdrawl Period on the I-131 Uptake Estimation Using Tc-99 m Thyroid Scanning in Graves' Disease.","authors":"Hui Wang, Weijian Li, Pengpeng Chang, Qiang Jia, Jian Tan, Ruiguo Zhang","doi":"10.1210/clinem/dgae794","DOIUrl":"10.1210/clinem/dgae794","url":null,"abstract":"<p><strong>Purpose: </strong>The effect of methimazole withdrawal period (MWP) on the estimation of 24-hour-radioiodine thyroid uptake (131IU24h) from 99mTc-pertechnetate thyroid uptake (99mTcTU) remains unclear for patients with Graves' disease (GD). This study aims to investigate the feasibility and reliability of 99mTcTU-based 131IU24h estimation with different MWPs.</p><p><strong>Methods: </strong>We enrolled 116 GD patients scheduled for 131I therapy at our hospital between April 2022 and April 2023. Based on MWP, the patients were categorized as standard (no methimazole or MWP > 1 month), MWP1 (MWP ≤ 1 week), MWP2 (MWP > 1 week to ≤2 weeks), and MWP3 (MWP > 2 weeks to <1 month). Fisher's exact test, one-way ANOVA, or Kruskal-Wallis test were used to compare variables. Fitted curves of 99mTcTU20min vs 131IU24h were plotted for the standard group. Linear relationships and Bland-Altman plots were used to illustrate the relationship and consistency between estimated and measured 131IU24h.</p><p><strong>Results: </strong>131IU24h was higher in the MWP1 group compared to MWP2 (70.22 ± 7.95% vs 61.92 ± 9.84%, P = .001), and thyroid mass was greater in the MWP1 group (36.15 ± 22.38 g) vs MWP3 (21.25 ± 11.90 g, P = .005). The relationship between 131IU24h and 99mTcTU20min in the standard group is described by the following algorithm: estimated 131IU24h = 11.3ln (99mTcTU20min) + 39.4 (R2 = 0.62). Based on it, the correlation between estimated and measured 131IU24h was weak in MWP1 and MWP2 (both P > .05) but strong in MWP3 (r = 0.66, P = .002). Additionally, the agreement between estimated and measured 131IU24h was highest in the MWP3 group (95% confidence interval, -15.86 to 15.52%) compared to the MWP1and MWP2 groups.</p><p><strong>Conclusion: </strong>Estimated 131IU24h based on 99mTcTU is not suitable for GD patients with MWP less than 2 weeks at our institution, necessitating further prospective multicenter studies for validation.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"2273-2279"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631751","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":"Causal Effects of Metabolic Syndrome on Gastric Disorders: Univariable and Multivariable Mendelian Randomization.","authors":"Bowen Li, Jianguo Xu, Qingyong Zheng, Jie Gao, Qian Ren, Yongning Zhou","doi":"10.1210/clinem/dgae843","DOIUrl":"10.1210/clinem/dgae843","url":null,"abstract":"<p><strong>Context: </strong>Metabolic syndrome (MetS) has been associated with various gastrointestinal disorders, but the causal relationships between MetS components and gastric disorders remain unclear. Previous observational studies are limited by confounding factors and reverse causation.</p><p><strong>Objectives: </strong>This study aimed to investigate the causal effects of MetS components, including fasting blood glucose (FBG), high-density lipoprotein cholesterol (HDL-C), triglycerides (TGs), waist circumference (WC), and hypertension, on the risks of chronic gastritis, benign gastric tumors, and gastric cancer using mendelian randomization (MR) analyses.</p><p><strong>Methods: </strong>Univariable 2-sample mendelian randomization (TSMR) and multivariable mendelian randomization (MVMR) analyses were employed to evaluate the independent and combined effects of MetS components on gastric disorders. The primary MR method used was the random effects inverse-variance weighted (IVW) approach.</p><p><strong>Results: </strong>Univariable TSMR analysis identified statistically significant associations between elevated TGs (odds ratio [OR] = 1.223, 95% CI, 1.011-1.480; P = .0386) and reduced HDL-C (OR = 0.833, 95% CI, 0.701-0.989; P = .037) with an increased risk of benign gastric tumors. However, these associations were not confirmed by MVMR for TGs (OR = 1.187, 95% CI, 0.891-1.581; P = .2408) or HDL-C (OR = 0.989, 95% CI, 0.758-1.289; P = .932). Both TSMR (OR = 0.585, 95% CI, 0.411-0.831; P = .003) and MVMR (OR = 0.558, 95% CI, 0.334-0.930; P = .025) indicated that hypertension is associated with a reduced risk of gastric cancer. No statistically significant associations were found for other MetS components and gastric disorders.</p><p><strong>Conclusion: </strong>The findings suggest that specific MetS components, such as TGs and HDL-C, may affect the risk of benign gastric tumors, while hypertension might reduce the risk of gastric cancer. This study highlights the need for further research to understand the underlying mechanisms and potential indirect effects between MetS components and gastric disorders.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2498-e2509"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829971","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":"Genetics and Bone Mineral Density Predict the Fractures in Adults With Osteogenesis Imperfecta: A Prospective Study.","authors":"Camille Blandin, Corinne Collet, Agnes Ostertag, Thomas Funck-Brentano, Martine Cohen-Solal","doi":"10.1210/clinem/dgae791","DOIUrl":"10.1210/clinem/dgae791","url":null,"abstract":"<p><strong>Context: </strong>Osteogenesis imperfecta (OI) is a rare genetic bone disorder characterized by recurrent fractures. In adults, the value of bone mineral density (BMD) in fracture risk is unknown.</p><p><strong>Objective: </strong>We prospectively investigated changes in BMD over time and analyzed the determinants of fracture in OI.</p><p><strong>Methods: </strong>Among 106 individuals with grade 1 and 4 OI in the Reference Centre of Rare Bone Diseases in Paris, we included those with BMD measurements at 1 or more skeletal sites (hip, lumbar spine, radius) from 2000 to 2022.</p><p><strong>Results: </strong>For 71 individuals with reliable measurements (44 women, 8 postmenopausal; mean age 41.4 ± 13.7 years), baseline BMD was low at the lumbar spine only (mean Z-score -2.3 ± 1.5), affecting mainly men (mean Z-score -3 ± 1.6). Longitudinal changes were assessed for a median follow-up of 5.1 years (interquartile range 3.2-8.8). On adjustment for age, sex, and body mass index, BMD did not significantly change at any site. Logistic regression analysis revealed a high probability of fracture with baseline BMD Z-score <-2 SD vs ≥-2 SD [odds ratio 4.38, 95% confidence interval (CI) 1.10-21.75, P = .048] and harboring splicing, stop codon, and frameshift variants of COL1 gene (odds ratio 29.8, 95% CI 2.56-1503, P = .024).</p><p><strong>Conclusion: </strong>Our OI cohort showed low BMD at the lumbar spine but no significant change at any site after a median of 5.0 years of follow-up. The probability of fracture was associated with baseline BMD Z-score <-2 SD vs ≥-2 SD and harboring COL1 splicing, stop codon, and frameshift variants.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"2307-2313"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dasiglucagon in Children With Congenital Hyperinsulinism Up to 1 Year of Age: Results From a Randomized Clinical Trial.","authors":"Diva D De Leon, Indraneel Banerjee, Sebastian Kummer, Sune Birch, Eva Bøge, Jelena Ivkovic, David M Kendall, Paul S Thornton","doi":"10.1210/clinem/dgae818","DOIUrl":"10.1210/clinem/dgae818","url":null,"abstract":"<p><strong>Context: </strong>Congenital hyperinsulinism (CHI) is a cause of persistent hypoglycemia in childhood with a considerable risk of lifelong neurological sequelae. Available pharmacological therapies are limited. Dasiglucagon is a glucagon analog for the treatment of hypoglycemia.</p><p><strong>Objective: </strong>To assess the efficacy and safety of dasiglucagon in children with CHI up to 1 year of age.</p><p><strong>Methods: </strong>This study included a randomized, crossover, double-blind, placebo-controlled part 1 and an open-label, single-arm part 2 at 4 centers in Germany, the United Kingdom, and the United States. Participants comprised children with CHI aged 7 days to 12 months who were dependent on IV glucose. In part 1, participants were randomized to dasiglucagon or placebo for 48 hours, then crossed over to the other treatment for 48 hours. In part 2, all participants received dasiglucagon for 21 days. The primary outcome was mean IV glucose infusion rate (GIR) in the last 12 hours of part 1.</p><p><strong>Results: </strong>Between June 19, 2020, and February 9, 2022, 12 eligible participants were randomized to dasiglucagon-placebo (n = 7) or placebo-dasiglucagon (n = 5). The IV GIR was significantly reduced with dasiglucagon compared with placebo (least-squares mean 4.3 mg/kg/min [95% confidence interval [CI], 1.04 to 7.60 mg/kg/min] and 9.5 mg/kg/min [95% CI, 6.24 to 12.81 mg/kg/min], respectively; P = .004). The most frequent adverse events in both treatment groups were gastrointestinal, dermatological, and metabolism and nutritional disorders.</p><p><strong>Conclusion: </strong>In infants with CHI, dasiglucagon significantly reduced the amount of IV glucose needed to maintain euglycemia compared with placebo. Dasiglucagon represents a promising treatment for the management of CHI.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2674-e2681"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on Physical, Psychological, and Quality of Life Management in Klinefelter Syndrome.","authors":"Brien Mehmet, Andrew A Dwyer, Channa N Jayasena, Steve Gillard, Sofia Llahana","doi":"10.1210/clinem/dgaf261","DOIUrl":"10.1210/clinem/dgaf261","url":null,"abstract":"<p><strong>Context: </strong>Klinefelter syndrome (KS), most commonly arises from a 47,XXY karyotype. While KS affects around 1 in 450 to 600 male births, an estimated 50% to 75% of cases go undiagnosed. Individuals with KS are at increased risk of metabolic, cardiovascular, and reproductive comorbidities, increasing mortality risk, psychological burden, and significantly diminished health-related quality of life (HR-QoL) compared to healthy controls. We provide an updated review of the recent literature on the clinical management for people with KS, associated comorbidities, and the implications on HR-QoL.</p><p><strong>Evidence acquisition: </strong>A comprehensive literature search was conducted of key databases MEDLINE, CINAHL, Cochrane, Psychinfo, and EMBASE, followed by a gray search of relevant key papers in KS with medical guideline organizations being searched online and, where available, their publications and proposed guidelines being assessed. All databases were searched from their inception until December 2024, and English-language restrictions applied.</p><p><strong>Evidence synthesis: </strong>Current evidence highlights the need for early detection, the importance of appropriate medication management, and multidisciplinary care to address infertility, cancer risks, neurocognitive deficits, and adverse mental health. Lifespan-specific interventions remain underexplored, necessitating further research to optimize outcomes and refine clinical guidelines.</p><p><strong>Conclusion: </strong>KS management is guided by only one endorsed guideline. International and interprofessional collaboration is needed to develop consensus documents. Existing guidelines pay minimal attention to the numerous HR-QoL challenges, overlooking the effect and diagnosis of psychological comorbidities. Enhancing HR-QoL and optimizing physical and mental well-being should be prioritized to improve HR-QoL outcomes in people with KS.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2435-e2445"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mitochondrial Puzzle: Why Obesity Affects Insulin Sensitivity Differently in Black and White Women.","authors":"Teresa Vezza, Víctor M Víctor","doi":"10.1210/clinem/dgae686","DOIUrl":"10.1210/clinem/dgae686","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2793-e2794"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367280","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":"Autoimmune Disease is Increased in Women With Primary Ovarian Insufficiency.","authors":"Victoria Wang, Jessica A Walsh, JoAnn Zell, Lauren E Verrilli, Joseph M Letourneau, Erica B Johnstone, Kristina Allen-Brady, Corrine K Welt","doi":"10.1210/clinem/dgae828","DOIUrl":"10.1210/clinem/dgae828","url":null,"abstract":"<p><strong>Context: </strong>Autoimmune disease is common in women with primary ovarian insufficiency (POI), and the genetic etiology of autoimmune disease suggests that it could be hereditary in families of women with POI.</p><p><strong>Objective: </strong>We hypothesized that a subset of women with POI and their family members would have an increased risk for autoimmune disorders.</p><p><strong>Design: </strong>Population-based study using electronic health records from 1995 to 2022.</p><p><strong>Setting: </strong>Two major Utah healthcare systems serving 85% of the state.</p><p><strong>Subjects: </strong>Women with POI (n = 610) were identified using International Classification of Diseases (ICD) codes and charts were reviewed for accuracy. First-, second-, and third-degree relatives were identified using genealogy data in the Utah Population Database.</p><p><strong>Intervention: </strong>Autoimmune diagnoses were identified using ICD codes.</p><p><strong>Main outcome measures: </strong>The relative risk of autoimmune disease in women with POI and relatives was estimated by comparison to population rates.</p><p><strong>Results: </strong>At least 1 autoimmune disease was identified in 25% of women with POI. The relative risk of autoimmune hypothyroidism (odds ratio [95% confidence interval] 6.88 [5.71, 8.22]; P < .001), adrenal insufficiency (4.72 [1.73, 10.28]; P = .0020), type 1 diabetes (4.13 [2.14, 7.22]; P = 5.25X10-5), rheumatoid arthritis (5.66 [3.10, 9.50]; P = 3.70X10-7), vitiligo (15.33 [6.16, 31.58]; P = 5.25X10-7), celiac disease (7.58 [3.47, 14.39]; P = 4.47X10-6), psoriasis (3.90 [2.01, 6.81]; P = 9.04X10-5) and systemic lupus erythematosus (4.43 [1.63, 9.64]; P = .0027) were increased in women with POI compared to population rates. There was no increased risk of autoimmune disease in family members.</p><p><strong>Conclusion: </strong>Data confirm increased autoimmune disease in women with POI. The increased risk is largely related to autoimmune polyglandular syndrome types 1 through 4 and autoimmune hypothyroidism. The absence of risk in family members may result from differences in environmental influences or hormone milieu.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e2614-e2620"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261096/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delineating the Psychiatric Morbidity Spectrum in Congenital Adrenal Hyperplasia: A Population-based Registry Study.","authors":"Marie Lind-Holst, Dorte Hansen, Katharina Maria Main, Anders Juul, Marianne Skovsager Andersen, Morten Dunø, Åse Krogh Rasmussen, Niels Jørgensen, Claus Højbjerg Gravholt, Agnethe Berglund","doi":"10.1210/clinem/dgae780","DOIUrl":"10.1210/clinem/dgae780","url":null,"abstract":"<p><strong>Context: </strong>Clinical studies of psychiatric morbidity in patients with congenital adrenal hyperplasia (CAH) imply impaired mental health.</p><p><strong>Objective: </strong>To delineate psychiatric morbidity in a national CAH cohort by using complete data on psychiatric diagnoses from all Danish hospitals between 1977 and 2018 and on all psychiatric medication prescribed between 1995 and 2018.</p><p><strong>Design: </strong>A registry-based cohort study.</p><p><strong>Setting: </strong>A uniform public health care system.</p><p><strong>Patients and controls: </strong>Four hundred and forty-eight patients (females: n = 215) with CAH, of which 410 had 21-hydroxylase deficiency (21-OHD) (females: n = 255) and 44 527 were age- and sex-matched general population controls.</p><p><strong>Main outcome measures: </strong>Diagnoses were analyzed by negative binomial regression yielding incidence rate ratios (IRR). Medication were analyzed by Cox regression yielding hazard ratios (HR).</p><p><strong>Results: </strong>21-OHD was associated with an increased risk of any psychiatric diagnosis; females: IRR = 2.32 (CI, 1.48-3.64), males: IRR = 2.74 (CI, 1.31-5.71) as well as of medication related to psychiatric disorders; females: HR = 1.74 (CI, 1.42-2.13), males: HR = 1.74 (CI, 1.30-2.33). Both females and males with 21-OHD had a significantly increased risk of alcohol use, stress and adjustment disorders, and of suicidal behavior. For patients with more rare forms of CAH (n = 24), the risk of any psychiatric diagnosis was significantly increased for males, IRR = 12.85 (CI, 1.78-92.87), but not for females, IRR = 0.54 (CI, 0.10-3.00). The risk of being prescribed psychiatric medication was not increased for neither females, HR = 1.05 (CI, 0.39-2.84), nor males, HR = 0.72 (CI, 0.10-5.13), with rare forms of CAH.</p><p><strong>Conclusion: </strong>21-OHD is associated with a significantly increased psychiatric morbidity. This study underlines a need for awareness of mental health in patients with 21-OHD.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"2147-2156"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640178","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":"F2-Isoprostanes Are Associated With Increased Fracture Risk in Type 2 Diabetes.","authors":"Bowen Wang, Ruban Dhaliwal, Susan K Ewing, Ann V Schwartz, Deepak Vashishth","doi":"10.1210/clinem/dgae788","DOIUrl":"10.1210/clinem/dgae788","url":null,"abstract":"<p><strong>Context: </strong>Fracture risk is higher in type 2 diabetes (T2D) for a given bone mineral density (BMD) level. Increased oxidative stress in T2D induces diabetic complications and may affect T2D bone fragility.</p><p><strong>Objective: </strong>To investigate whether the levels of plasma F2-isoprostanes, a reliable oxidative stress marker, are associated with incident clinical fracture risk in older adults with diabetes.</p><p><strong>Methods: </strong>An observational cohort study was conducted in a well-characterized cohort from Health, Aging, and Body Composition study.</p><p><strong>Participants: </strong>Older Black and White ambulatory adults with baseline plasma F2-isoprostanes measurements (baseline age 70-79 years, T2D: N = 132; nondiabetes: N = 571) were selected from the study cohort of 3075 individuals. Risk of incident clinical fractures was assessed.</p><p><strong>Results: </strong>In the Cox proportional hazard model with multivariate adjustments (including BMD, medications, and other risk factors), a 93% increase in incident clinical fracture risk was significantly associated with each SD increase in log plasma F2-isoprostanes in the T2D group (hazard ratio [HR] = 1.93 [95% CI, 1.26-2.9] P = .002), but there was no evidence of an association in the nondiabetes group (HR = 0.98 [95% CI 0.81-1.18] P = .79, P for interaction <.001). Log plasma F2-isoprostanes were moderately correlated with a decline in baseline total hip BMD (r = -0.25, P = .003), and with a 4-year decrease in total hip BMD (r = -0.28, P = .008) in T2D. There was no evidence of correlation between log plasma F2-isoprostanes and circulating glycoxidation markers or bone turnover markers in either group.</p><p><strong>Conclusion: </strong>Plasma F2-isoprostanes levels in individuals with diabetes are associated with increased incident clinical fracture risk independently of baseline BMD.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"2299-2306"},"PeriodicalIF":5.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12261098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}