Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"Response to Letter to the Editor from Zhang et al.: Cabozantinib plus ipilimumab/nivolumab in patients with previously treated advanced differentiated thyroid cancer.","authors":"Bhavana Konda, Eric J Sherman, Erminia Massarelli, Jorge Nieva, Jameel Muzaffar, John C Morris, Mabel Ryder, Alan L Ho, Mark Agulnik, Lai Wei, Demond Handley, Catherine Moses, Rajani Jacob, John Wright, Howard Streicher, William Carson, Manisha H Shah","doi":"10.1210/clinem/dgaf221","DOIUrl":"https://doi.org/10.1210/clinem/dgaf221","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784635","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 Zhang et al.: 'Cabozantinib plus ipilimumab/nivolumab in patients with previously treated advanced differentiated thyroid cancer'.","authors":"Yaoyu Zhang, Yingying Zhao, Tao Deng, Wenjun Meng","doi":"10.1210/clinem/dgaf220","DOIUrl":"https://doi.org/10.1210/clinem/dgaf220","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784634","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":"Bone Marrow Adiposity Assessed by HRpQCT Is Related to Fracture Risk and Bone Mineral Density in Older Swedish Women.","authors":"Michail Zoulakis, Kristian F Axelsson, Henrik Litsne, Lisa Johansson, Mattias Lorentzon","doi":"10.1210/clinem/dgaf216","DOIUrl":"https://doi.org/10.1210/clinem/dgaf216","url":null,"abstract":"<p><strong>Context: </strong>Recent research links bone marrow adiposity (BMAT) to osteoporosis and fracture risk. Typically, BMAT is assessed via magnetic resonance imaging (MRI), a costly and less accessible method. A new method uses high-resolution peripheral quantitative computed tomography (HR-pQCT) to quantify BMAT.</p><p><strong>Objective: </strong>To investigate if BMAT, derived from HR-pQCT images, is associated with fracture incidence and osteoporosis prevalence in older women.</p><p><strong>Methods: </strong>2984 women aged 75-80 years from the SUPERB cohort were included between March 2013 and May 2016. Bone characteristics, including bone densitometry (DXA) and HR-pQCT of the ultra-distal tibia, were assessed. Bone marrow fat fraction (BMFF) was measured using HR-pQCT. Incident fractures were tracked until March 2023. Linear regression was used to analyze associations between BMFF, anthropometrics, and bone mineral density (BMD). Cox and Poisson regression examined BMFF's association to incident fractures.</p><p><strong>Results: </strong>BMFF was inversely associated to body mass index (r= -0.21, p < 0.001) and hip BMD (r = -0.50, p < 0.001). Over a median follow-up of 7.3 years, 797 major osteoporotic fractures (MOF), 1069 any fractures, and 235 hip fractures occurred. Higher BMFF (per SD) increased the risk of MOF (HR = 1.24, 95% CI 1.15-1.34), any fracture (HR = 1.20, 95% CI 1.12-1.28), hip fracture (HR = 1.22, 95% CI 1.06-1.40), and vertebral fracture (HR = 1.24, 95% CI 1.12-1.38) in multivariable Cox models adjusted for age, body mass index and clinical risk factors. Mediation analysis indicated that a significant proportion of these associations were mediated by femoral neck bone mineral density (FN-BMD).</p><p><strong>Conclusion: </strong>Higher BMFF is associated with lower BMD and higher fracture risk in older women.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781306","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":"Plasma levels of small HDL particles are associated with coronary atherosclerosis progression in adults with diabetes.","authors":"Bruna S B S Teles, Sergio H R Ramalho, Márcio S Bittencourt, Isabela M Benseñor, Michael J Blaha, Peter P Toth, Steven R Jones, Raul D Santos, Paulo A Lotufo, Luiz Sérgio F Carvalho","doi":"10.1210/clinem/dgaf215","DOIUrl":"https://doi.org/10.1210/clinem/dgaf215","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is a major driver of coronary atherosclerosis progression, yet its impact is highly heterogeneous. Insulin resistance contributes to a complex interplay of metabolic disturbances that accelerate atherogenesis to varying degrees. Identifying biomarkers that refine cardiovascular risk prediction in this population remains a clinical priority.</p><p><strong>Objective: </strong>To evaluate the association between small HDL particle concentration and the incidence/progression of coronary artery calcium (CAC) in individuals with T2DM.</p><p><strong>Methods: </strong>We analyzed 4,331 participants from the ELSA-Brasil cohort. CAC incidence/progression was compared between individuals with and without T2DM. A subgroup of 461 non-statin users with T2DM and no baseline atherosclerotic cardiovascular disease (ASCVD) was further assessed for associations between small HDL particles (<8nm, HDLp1) and CAC outcomes.</p><p><strong>Results: </strong>Individuals with T2DM showed increased CAC incidence/progression rates compared to non-diabetic participants. Among 461 non-statin users with T2DM, 143 (31.0%) experienced CAC incidence/progression. Higher plasma concentrations of HDLp1 (3rd tertile) were associated with a 140% (95%CI 32-341%, p<0.001) greater likelihood of CAC incidence/progression compared to the 1st tertile. The inclusion of HDLp1 significantly improved CAC risk classification, with a net reclassification improvement (NRI) of 13.6% (95%CI 2.8-18.8%, p=0.004).</p><p><strong>Conclusion: </strong>HDLp1 concentration is significantly associated with CAC incidence/progression in individuals with T2DM and may improve risk discrimination for coronary atherosclerosis progression in this population.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774667","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":"Thyroid Hormone Sensitivity as a Possible Determinant of Metabolic Phenotypes in Young Adults, Not in the Elderly.","authors":"Min-Hee Kim, Jeongmin Lee, Dong-Jun Lim, Kyle Masato Ishikawa, James Davis, Eunjung Lim, Hyeong Jun Ahn","doi":"10.1210/clinem/dgaf214","DOIUrl":"https://doi.org/10.1210/clinem/dgaf214","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the association between thyroid sensitivity indices and metabolic phenotypes, including metabolically healthy and unhealthy individuals with obesity (MHO, MUO) and normal weight (MHNW, MUNW), focusing on age-specific differences.</p><p><strong>Methods: </strong>Data from participants aged ≥18 years in the National Health and Nutrition Examination Survey (NHANES) 2007-2012 were analyzed. Thyroid sensitivity indices, including the Thyroid Feedback Quantile-based Index (TFQI), Thyroid-Stimulating Hormone Index (TSHI), and Thyrotroph Thyroxine Resistance Index (TT4RI), were calculated. Multivariable regression and piecewise regression analyses were performed to examine associations between metabolic phenotypes and thyroid sensitivity indices, stratified by age groups (<65 and ≥65 years).</p><p><strong>Results: </strong>In the total population, the MUO group exhibited the significantly higher values for TSHI (p = 0.035) compared to the MHNW group, while there were borderline and no significant differences for TT4RI (p = 0.093) and TFQI (p = 0.134), respectively. Among younger adults (<65 years), MUO showed the highest values for TSHI (β = 0.122, p = 0.006), TT4RI (β = 2.006, p = 0.010), and TFQI (β = 0.058, p = 0.018), with significant linear and quadratic trends (p < 0.05). No significant associations were observed in older adults (≥65 years).</p><p><strong>Conclusions: </strong>Our findings highlight the importance of thyroid sensitivity indices in understanding metabolic health, particularly among younger adults. Incorporating these indices into clinical assessments may enhance metabolic phenotype stratification and inform targeted management of obesity.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781307","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":"Testosterone Effects on Short-Term Physical, Hormonal, and Neurodevelopmental Outcomes (TESTO) in Infants with 47,XXY.","authors":"Shanlee M Davis, Susan Howell, Jennifer Janusz, Najiba Lahlou, Regina Reynolds, Talia Thompson, Karli Swenson, Rebecca Wilson, Judith L Ross, Philip S Zeitler, Nicole R Tartaglia","doi":"10.1210/clinem/dgaf217","DOIUrl":"https://doi.org/10.1210/clinem/dgaf217","url":null,"abstract":"<p><strong>Context: </strong>47,XXY/Klinefelter syndrome (XXY) is associated with impaired testicular function and differences in physical growth, metabolism, and neurodevelopment. Clinical features of XXY may be influenced by testosterone during the mini-puberty period of infancy.</p><p><strong>Objective: </strong>We tested the hypothesis that exogenous testosterone treatment positively affects short-term physical, hormonal, and neurodevelopmental outcomes in infants with XXY.</p><p><strong>Design: </strong>Double-blind randomized controlled trial, 2017-2021.</p><p><strong>Setting: </strong>US tertiary care pediatric hospital.</p><p><strong>Patients: </strong>Infants 30-90 days of age with prenatally identified, non-mosaic 47,XXY (n=71).</p><p><strong>Intervention: </strong>Testosterone cypionate 25mg intramuscular injections every 4 weeks for 3 doses.</p><p><strong>Main outcome measures: </strong>The a priori primary outcomes were change in percent fat mass (%FM) z-scores and change in the total composite percentile on Alberta Infant Motor Scales (AIMS) assessment from baseline to 12 weeks.</p><p><strong>Results: </strong>The between group difference in change in %FM z-scores was -0.57 [95% CI -1.1, -0.06], p=0.03), secondary to greater increases in lean mass in the testosterone-treated group (1.5±0.4 kg vs 1.2±0.4, p=0.001). Testosterone suppressed gonadotropins and inhibin B (p<0.001 for all). In contrast, there were no significant group differences in short term motor, cognitive, or language outcomes (p>0.15 for all).</p><p><strong>Conclusions: </strong>In this double-blind randomized controlled trial in infants with XXY, testosterone injections resulted in physical effects attributable to systemic androgen exposure, however this dose suppressed the hypothalamic-pituitary-gonadal axis. Neurodevelopment outcomes were not impacted by treatment. These results do not support routine testosterone treatment in infants with XXY, however long term follow up on physical health, neurodevelopment and testicular function is needed.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774668","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: \"Insulin Signaling Through the Insulin Receptor Increases Linear Growth Through Effects on Bone and the GH-IGF-1 Axis\".","authors":"","doi":"10.1210/clinem/dgaf186","DOIUrl":"https://doi.org/10.1210/clinem/dgaf186","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774652","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":"Assessing the Cardiovascular Effects of Levothyroxine Use in an Ageing United Kingdom population (ACEL-UK): Cohort Study.","authors":"Mia Holley, Salman Razvi, Ian Maxwell, Rosie Dew, Scott Wilkes","doi":"10.1210/clinem/dgaf208","DOIUrl":"https://doi.org/10.1210/clinem/dgaf208","url":null,"abstract":"<p><strong>Context: </strong>Thyroid stimulating hormone (TSH) levels tend to rise with age, but standard reference intervals do not reflect this, potentially leading to overdiagnosis of subclinical hypothyroidism (SCH) and excessive levothyroxine (LT4) prescriptions in older adults.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted utilising data from United Kingdom Primary Care patients from The Health Improvement Network, to compare outcomes in adults over 50 years with SCH who were either prescribed or not prescribed LT4. The primary outcome was cardiovascular events (angina, myocardial infarction, peripheral vascular disease, stent procedures, or stroke). Secondary outcomes included bone events (fragility fractures or osteoporosis) and all-cause mortality. Time-varying hazard ratios adjusted for relevant factors were estimated.</p><p><strong>Results: </strong>This study included 53,899 patients (baseline median age 67 years (IQR: 59-76); 68.5% female; median TSH 4.6mU/L (IQR: 4.1-5.4). Median follow-up duration was 10 years (IQR: 5.5-10.0). Of these, 19,952 (37%) received LT4 and 33,947 (63%) did not. LT4 therapy showed a protective effect against cardiovascular events (HR: 0.91; 95% CI: 0.87-0.97; p < 0.001) but increased risk of bone events (HR: 1.21; 95% CI: 1.14-1.28; p < 0.001) and all-cause mortality (HR: 1.17; 95% CI: 1.13-1.22; p < 0.001).</p><p><strong>Conclusions: </strong>Our data suggests that LT4 therapy in older individuals with SCH is associated with a trade-off between the potentially beneficial effect on cardiovascular risk and the deleterious relationship with bone health and mortality risk. These risks need to be considered, mitigated and discussed when LT4 therapy is being deliberated in older patients with SCH.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781303","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":"Characterizing Disparities in Access to Surgery for Pituitary Adenomas: A National Cancer Database Analysis.","authors":"Miguel Angel Jimenez, Melanie A Horowitz, Julian L Gendreau, Bakhtiar Yamini, A Karim Ahmed, Mathew Geltzeiler, Olabisi Sanusi, Eric W Wang, Carl H Snyderman, Garret W Choby, Georgios A Zenonos, Paul A Gardner, Nicholas R Rowan, Debraj Mukherjee","doi":"10.1210/clinem/dgaf212","DOIUrl":"https://doi.org/10.1210/clinem/dgaf212","url":null,"abstract":"<p><strong>Context: </strong>Although there is an established improved postoperative outcome for pituitary adenomas (PA) surgically resected at high-volume facilities (HVFs), access to these centers may not be equitable.</p><p><strong>Objective: </strong>To investigate the racial and socioeconomic differences that lead to unequal distribution of access for PAs at HVFs in the United States.</p><p><strong>Design and patients: </strong>Retrospective analysis of data from the National Cancer Database (NCDB) from 2004 to 2019 on 57,807 patients with PA.</p><p><strong>Main outcome measures: </strong>Baseline description of patients treated at HVFs, survival outcomes, and predictors of survival were evaluated in patients with PA.</p><p><strong>Results: </strong>A total of 47.6% (n = 27,523) underwent surgery at a HVF. On multivariable analysis, African-American race (OR: 0.89, p < 0.001) and Hispanic ethnicity (OR: 0.80, p < 0.001) had significantly lower odds of having a surgical procedure at a HVF, as compared to a reference Caucasian population. Patients from rural locations (OR: 0.79, p = 0.003; reference = urban); with Medicaid insurance (OR: 0.86, p < 0.001; reference = private); those with lower-income (< $40,227 [OR: 0.93, p = 0.049]; reference = ≥ $63,333); and patients from zip codes with large percentages of adults who did not graduate high school (≥ 17.6% [OR: 0.95, p < 0.001]; reference = < 6.3%) were significantly less likely to have surgery at a HVF. An increasing trend in access to surgical care at HVFs for PA patients over time was demonstrated (e. g., 2005 [OR = 1.10 (0.97-1.26, p = 0.173] vs. 2019 [OR = 1.27 (1.13-1.43), p < 0.001]).</p><p><strong>Conclusion: </strong>There is significant racial and socioeconomic disparities in access to HVFs for adult patients seeking surgical resection of pituitary adenomas.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765737","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":"Wake Up and Smell - the Cortisol?","authors":"Joanna L Spencer-Segal, Richard J Auchus","doi":"10.1210/clinem/dgaf197","DOIUrl":"https://doi.org/10.1210/clinem/dgaf197","url":null,"abstract":"","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765537","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}