Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"Corticosteroid Use and Long-Term Changes in Weight and Waist Circumference: The Lifelines Cohort Study.","authors":"Mostafa Mohseni, Eline S van der Valk, Maartje J B Van der Hurk, Mesut Savas, Mariëtte R Boon, Elisabeth F C van Rossum","doi":"10.1210/clinem/dgaf166","DOIUrl":"https://doi.org/10.1210/clinem/dgaf166","url":null,"abstract":"<p><strong>Context: </strong>The use of corticosteroids (CS) has been associated with higher body mass index (BMI) and waist circumference (WC) in cross-sectional studies. However, longitudinal data are scarce, particularly for locally administered forms.</p><p><strong>Design: </strong>We analyzed weight and waist circumference changes in 81 361 Lifelines Cohort Study participants (mean age 46.3 years, mean BMI 26.0 kg/m2, 41% male, mean follow-up 3.9 years) via linear regression. Sensitivity analyses included stratification by sex and BMI. Short-term weight changes post-start were assessed in a subset using linear mixed-effect models.</p><p><strong>Results: </strong>We found 23.8% CS users during the study period. Individuals reporting any new use of CS gained significantly more weight compared to nonusers at follow-up (β .034 kg/year, P = .021), particularly among those initiating local CS use (β .037 kg/year, P = .017). Use of new systemic CS was associated with increased WC (β .200 cm/year, P < .001). Discontinuation of CS led to decreased WC (β -.078 cm/year, P = .028). These effects were particularly observed in female participants and individuals with BMI ≥25 kg/m2, but not in male participants and those with BMI < 25 kg/m2. Short-term weight-inducing effects of CS were not observed in the weeks after initiation of CS use.</p><p><strong>Conclusion: </strong>This study demonstrates that CS use, including locally administered forms, is associated with long-term increases in weight and WC, notably in female individuals and those with overweight or obesity. Discontinuing CS was linked to reductions in WC. These findings underscore the need to carefully assess chronic systemic and local CS use, as discontinuation could benefit obesity-related outcomes in certain patients.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042287","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":"Regional Brain Structure Alterations in Diabetes but Not Prediabetes: the Shanghai Changfeng Study.","authors":"Liangqi Wang, Huandong Lin, Zehua Zhao, Lingyan Chen, Li Wu, Ting Liu, Jing Li, Chu-Chung Huang, Chun-Yi Zac Lo, Xin Gao","doi":"10.1210/clinem/dgaf248","DOIUrl":"https://doi.org/10.1210/clinem/dgaf248","url":null,"abstract":"<p><strong>Context: </strong>Diabetes impacts brain volume and white matter hyperintensity (WMH), but whether regional gray matter volume (GMV) and tract-specific WMH progress in the prediabetes stage remains unclear.</p><p><strong>Objective: </strong>We investigate brain structural changes across three distinct glycemic states.</p><p><strong>Methods: </strong>We analyzed 512 participants (122 with diabetes, 109 with prediabetes, and 281 controls) using advanced neuroimaging techniques. High-resolution structural T1-weighted MR images and FLAIR images were acquired, complemented by cognitive assessments, grip strength measurements, and gait speed testing. We performed correlational analyses to examine the relationships between observed brain changes, cognitive performance, and motor function across different levels of glycemic states.</p><p><strong>Results: </strong>We found substantial changes in GMV in diabetes, especially in areas responsible for movement and coordination, including the bilateral cerebellum, right precentral gyrus, and left postcentral gyrus (P < 0.001 uncorrected with cluster size > 500). These brain changes were associated with decreases in cognitive test scores (MoCA, P = 0.04), gait speed (P < 0.05), and right-hand grip strength (P < 0.05) - effects not seen in the prediabetic group. We observed significantly higher WMH index across 20 tracts in diabetic brains (P < 0.05, FDR-corrected). Glycemic levels positively correlated with WMH index in multiple tracts (P < 0.05, FDR-corrected).</p><p><strong>Conclusions: </strong>This study illuminates diabetes as a powerful force in cerebral architecture, challenging the notion of a gradual decline beginning in prediabetes. These insights not only underscore the critical importance of diabetes prevention but also hint at the brain's remarkable resilience in the face of early metabolic challenges.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054634","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":"Effectiveness of the dual GIP/GLP1-agonist Tirzepatide in two cases of Alström syndrome, a rare obesity syndrome.","authors":"Moritz Ferch, Isabel Peitsch, Alexandra Kautzky-Willer, Susanne Greber-Platzer, Albert Friedrich Stättermayer, Michael Krebs, Thomas Scherer","doi":"10.1210/clinem/dgaf258","DOIUrl":"https://doi.org/10.1210/clinem/dgaf258","url":null,"abstract":"<p><strong>Background: </strong>Tirzepatide, a dual GIP/GLP-1 receptor agonist was recently approved for type 2 diabetes and weight management. Alström syndrome (AS) is a rare, genetic, multi-systemic disorder, characterized by cone-rod dystrophy, progressive hearing loss, obesity and diabetes with profound insulin resistance due to marked hyperphagia. Here we highlight the potential of tirzepatide as novel therapeutic option for improving glycemic outcomes, metabolic associated steatotic liver disease (MASLD) and effectively reducing body weight in individuals with AS.</p><p><strong>Methods: </strong>We present the first two reported cases of people living with AS treated with tirzepatide.</p><p><strong>Results: </strong>Two individuals with AS, previously treated with semaglutide received tirzepatide in our clinic. The first, a 23-year-old male with 18 months on treatment, experienced weight loss of -28 kg (113.6 kg to 83 kg, -26.9%); HbA1c decreased by -0.4% (6.7% to 6.3%), with considerable reductions in daily insulin doses of -96 IU/day (-83%; 58 to 20 IU insulin glargine and 58 to 0 IU prandial insulin), while maintaining oral antidiabetics. Hepatic steatosis, with a previous fat fraction of 20%, resolved as confirmed by MRI. The second, a 20-year-old male with previously well-controlled diabetes, was followed-up for 9 months and showed a weight reduction of -9.5 kg (132 kg to 122.5 kg; -7.2%) with a reduction of hepatic lipid content from 21% at the latest MRI to 11% after ∼3 months of therapy.</p><p><strong>Conclusion: </strong>Tirzepatide shows great effectiveness with regard to body weight, MASLD and insulin resistance in AS. Follow-up studies with larger cohorts have to be performed to confirm these findings.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058851","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":"SHBG, testosterone and type 2 diabetes risk in middle-aged African women: exploring the impact of HIV and menopause.","authors":"Julia H Goedecke, Clement Nyuyki Kufe, Maphoko Masemola, Mamosilo Lichaba, Ikanyeng D Seipone, Amy E Mendham, Hylton Gibson, James M Hawley, David M Selva, Itai M Magodoro, Andre Pascal Kengne, Tinashe Chikowore, Nigel J Crowther, Shane A Norris, Fredrik Karpe, Tommy Olsson, Karl-Heinz Storbeck, Lisa K Micklesfield","doi":"10.1210/clinem/dgaf256","DOIUrl":"https://doi.org/10.1210/clinem/dgaf256","url":null,"abstract":"<p><strong>Context: </strong>Sex hormone-binding globulin (SHBG) and testosterone are differentially associated with type 2 diabetes (T2D) risk.</p><p><strong>Objective: </strong>To investigate whether the associations between SHBG, testosterone and T2D risk differ by HIV and menopausal status in Black African women living with (WH) and without HIV (WOH).</p><p><strong>Design: </strong>Cross-sectional observational.</p><p><strong>Setting: </strong>Health Research Unit in Soweto, Johannesburg, South Africa.</p><p><strong>Participants: </strong>81 premenopausal (57 WOH, 24 WH) and 280 postmenopausal (236 WOH, 44 WH) women from the Middle-Aged Soweto Cohort (MASC).</p><p><strong>Main outcome measures: </strong>Circulating SHBG and sex hormones, body composition (dual energy x-ray absorptiometry), insulin sensitivity (Matsuda index), secretion (insulinogenic index, IGI) and clearance, and beta-cell function (disposition index, DI). Dysglycaemia was defined as either impaired fasting or postprandial glucose or T2D.</p><p><strong>Results: </strong>SHBG was higher and total and free testosterone were lower in postmenopausal WH than WOH (all p<0.023). Irrespective of HIV serostatus, SHBG was positively associated with Matsuda index, insulin clearance and DI and inversely with HOMA-IR (all p<0.011). The association between SHBG and Matsuda index was stronger in premenopausal than postmenopausal women (p=0.043 for interaction). Free testosterone (and not total testosterone) was only negatively associated with basal insulin clearance (p=0.021), and positively associated with HOMA-IR in premenopausal and not post-menopausal women (p=0.015 for interaction).</p><p><strong>Conclusions: </strong>We show for the first time that midlife African WH have higher SHBG and lower total and free testosterone than WOH, which corresponded to their higher beta-cell function, suggesting a putative protective effect of SHBG on T2D risk in WH.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013551","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":"Increased risk of cardiovascular diseases in patients with chronic hypoparathyroidism in Sweden.","authors":"Sigridur Björnsdottir, Michael Mannstadt, Bart Clarke, Tim Spelman, Olle Kämpe, Gianluigi Savarese","doi":"10.1210/clinem/dgaf257","DOIUrl":"https://doi.org/10.1210/clinem/dgaf257","url":null,"abstract":"<p><strong>Context: </strong>Data on cardiovascular outcomes in patients with chronic hypoparathyroidism (hypoPT) are limited.</p><p><strong>Objective: </strong>To investigate the risk of cardiovascular outcomes; acute myocardial infarction, atrial fibrillation/flutter, heart failure, valvular heart disease, peripheral artery disease and stroke/transient ischemic attack (TIA) in patients with chronic hypoPT.</p><p><strong>Design: </strong>The Swedish National Patient Registry, the Swedish Prescribed Drug Registry, and the Total Population Registry, 1997-2018.</p><p><strong>Settings: </strong>Population-based cohort study in Sweden.</p><p><strong>Patients: </strong>National registries were used to identify patients with chronic hypoPT and matched controls.</p><p><strong>Results: </strong>A total of 1,982 with chronic hypoPT and 19,499 controls were included. After adjustment for cardiovascular risk factors, patients with chronic hypoPT had higher risk of valvular heart disease (HR 2.08; 95% CI 1.67-2.60), peripheral artery disease (HR 1.78; 95% CI 1.41-2.26), heart failure (HR 1.66; 95% CI 1.44-1.90), atrial fibrillation/flutter (HR 1.58; 95% CI 1.38-1.81), acute myocardial infarction (HR 1.31; 95% CI 1.05-1.64) and fatal cardiovascular disease (HR 1.59; 95% CI 1.40-1.80) compared to matched controls. No significant difference in risk of stroke/TIA was observed. Cardiovascular outcomes did not differ between patients with surgical- and non-surgical chronic hypoPT. Females with hypoPT and a significantly increased risk of valvular heart disease, peripheral artery disease, heart failure, atrial fibrillation, myocardial infarction and fatal CV disease compared to female controls. There were no differences in any cardiovascular outcomes between males with hypoPT and male controls.</p><p><strong>Conclusion: </strong>The risk of cardiovascular diseases was increased in patients with chronic hypoPT, particularly among women. These findings highlight the need for close monitoring and preventive management of cardiovascular risk factors, especially in women.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006461","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":"Familial risk of Hashimoto's thyroiditis in a large genealogical database.","authors":"Melissa Bujnis, Kelsey DeSalvo, Deborah W Neklason, Micheal J Madsen, Lynn B Jorde","doi":"10.1210/clinem/dgaf251","DOIUrl":"https://doi.org/10.1210/clinem/dgaf251","url":null,"abstract":"<p><strong>Context: </strong>Autoimmune hypothyroidism, commonly known as Hashimoto's thyroiditis (HT), is an autoimmune thyroid disorder affecting approximately 5% of the United States population. Previous relative risk (RR) studies have suggested that first-degree relatives of individuals with HT are at ∼4.5 to 32 times higher risk for developing HT than the general population. Twin studies estimate high heritability for the development of HT (∼65%).</p><p><strong>Objective: </strong>In this study, we aimed to better estimate the HT RR in first, second, and third-degree relatives in the Utah Population Database (UPDB).</p><p><strong>Methods: </strong>From the UPDB, a total of 92,405 HT probands and 184,810 matched controls were identified, with 2,960,650 relatives of HT probands and 5,730,159 relatives of controls, making this the largest relative risk study of HT.</p><p><strong>Results: </strong>Females with HT in this cohort were 2.71-fold more common than males. The odds ratio (OR) of HT in the first-degree relatives of affected individuals is 1.77 (95% CI 1.74-1.80). The OR of HT in second-degree relatives is 1.23 (95% CI 1.22-1.27) and 1.11 (95% CI 1.10-1.12) in third-degree relatives of HT probands.. We also identified an increased OR of spouses to develop HT of 1.50 for husbands of affected wives (95% CI 1.39- 1.61) and 1.58 for wives of affected husbands (95% CI 1.47 - 1.70), suggesting a significant environmental component contributing to HT development.</p><p><strong>Conclusions: </strong>This is the first study to estimate an increased risk of HT for second- and third-degree relatives, who are less likely to share common environments than first-degree relatives.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042700","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":"Increased HSD11β1 Expression in Human Leiomyomatous Uteri: Implication for Enhanced Glucocorticoid Signaling.","authors":"Carrie Malcom, Ozlem Guzeloglu-Kayisli, Burak Un, Erika New, Busra Cetinkaya-Un, Xiaofang Guo, Emad Mikhail, Anthony Imudia, Charles Lockwood, Umit Kayisli","doi":"10.1210/clinem/dgaf255","DOIUrl":"https://doi.org/10.1210/clinem/dgaf255","url":null,"abstract":"<p><strong>Context: </strong>FK506-binding-protein-51 (FKBP51) is a glucocorticoid-induced co-chaperone protein previously shown to bind glucocorticoid receptor (GR), inhibiting its transcriptional activity. We previously found increased FKBP51 levels in uterine leiomyoma versus paired myometrium.</p><p><strong>Objective: </strong>To test the hypothesis that elevated FKBP51 levels contribute to leiomyoma pathogenesis by altering GR signaling.</p><p><strong>Design: </strong>RNA-sequencing was performed in leiomyoma cell cultures transfected with scramble or FKBP5-siRNA for 48-h, then treated with vehicle or dexamethasone (DEX) for 24-h. Differentially expressed genes, including HSD11B1, CNN1, and LAMA2 were analyzed by qPCR. Hydroxysteroid 11-beta dehydrogenase 1 (HSD11β1) expression was analyzed in leiomyoma, leiomyoma-adjacent paired myometrium, myometrium from patients without leiomyoma, and human endometrial stromal cells (HESC) by qPCR and immunohistochemistry.</p><p><strong>Setting: </strong>University-Research institution.</p><p><strong>Patients: </strong>Women with or without uterine leiomyoma.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>HSD11B1 mRNA and protein levels in leiomyoma, paired myometrium, and normal myometrium.</p><p><strong>Results: </strong>HSD11β1 expression was higher in paired myometrial and leiomyoma tissues versus normal myometrium (P<0.02). DEX treatment increased HSD11B1 transcription in normal myometrial and HESC cultures, but to a significantly greater extent in leiomyoma (P<0.001). However, FKBP5-silencing blunted this DEX-induced HSD11B1 upregulation. DEX-treatment reduced LAMA2 and increased CNN1 levels (coding for extracellular matrix and smooth muscle proteins, respectively) in FKBP5-silenced versus scramble siRNA-transfected leiomyoma cultures.</p><p><strong>Conclusions: </strong>FKBP51 not only inhibits but can augment GR-mediated transcription. Importantly, FKBP51-GR interactions increase HSD11B1 levels in leiomyoma cells, generating a pathological FKBP51-GR-HSD11β1 circle, altering transcription of downstream extracellular matrix and smooth muscle genes to induce a myofibroblast phenotype, thereby possibly contributing to leiomyoma pathogenesis.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038738","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":"Validation and limitations of the PANOMEN-3 predictive model for tumor recurrence and progression in pituitary tumors.","authors":"Marta Araujo-Castro, Edelmiro Menéndez Torre, Claudia-Lozano Aida, Rogelio García-Centeno, Laura González, Cindy Idrobo, Estefanía Achote, Ana Irigaray Echarri, María Dolores Moure Rodríguez-Argulló, Miguel Paja, Fernando Guerrero-Pérez, Justo P Castaño, María Dolores Ollero García, Cristina Novo-Rodríguez, Carmen Tenorio-Jimenéz, Rocío Villar-Taibo, Ignacio Bernabeu, Everardo Díaz-López, María Calatayud, Cristina Alvarez-Escola, Patricia Martín-Rojas, José María Recio-Córdova, Anna Aulinas, Queralt Asla Roca, María Dolores Aviles, Elena López Mezquita, María Fernández Argüeso, Inmaculada González Molero, Ignacio Ruz-Caracuel, Iban Aldecoa, Julia García, Elena Martínez-Sáez, Felicia Hanzu, Mónica Marazuela, Manel Puig-Domingo, Betina Biagetti","doi":"10.1210/clinem/dgaf252","DOIUrl":"https://doi.org/10.1210/clinem/dgaf252","url":null,"abstract":"<p><strong>Background: </strong>The aim of our study was to validate the classification proposed by the PANOMEN-3 group for the prediction of tumor recurrence/progression in pituitary tumors (PTs).</p><p><strong>Methods: </strong>Multicenter national case-control study of patients with PTs followed for at least 5 years. Kaplan-Meier curves were used to assess the time to tumor recurrence/progression. Uni- and multivariate Cox regression analyses were used to estimate the hazard ratio [HR] and prognostic capacity of the classification proposed by the PANOMEN-3 group.</p><p><strong>Findings: </strong>A total of 1143 patients were included. Pituitary surgery was performed in 814 patients and the remaining 329 patients were followed with active-surveillance or medical treatment. After a median follow-up of 8.8 years (5-29.8), 253 patients experienced tumor recurrence or biochemical/radiological progression and were classified as cases. The other 890 patients were classified as controls. The mean follow-up from PT diagnosis to recurrence was 7.2±5.4 years. The diagnostic accuracy of the PANOMEN-3 model to predict recurrence/progression was 75.6% (95% CI 0.716-0.796). Residual tumor (HR 2.20, p<0.001), hereditary syndrome (HR 5.15, p=0.026) and active secretory status (HR 1.80, p=0.021) were the most important variables in this model. Recurrence/progression rate increased with increasing PANOMEN-3 grade (2.5% in grade 0; 10.3% in grade 1, 33.7% in grade 2 and 33.3% in grade 3; p<0.001).</p><p><strong>Interpretation: </strong>The predictive model proposed by the PANOMEN-3 group may be useful to guide the prognosis and therapy of PTs in the Spanish population since it offers a good accuracy to predict tumoral/biochemical recurrence and/or progression in operated and non-operated patients.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055677","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":"Association between Muscle status and Bone Size, Density, and Strength in Type 1 Diabetes: A Cross-Sectional Study.","authors":"Inge Agnete Gerlach Brandt, Peter Vestergaard, Torben Harsløf, Claus Bogh Juhl, Nicklas Højgaard-Hessellund Rasmussen, Morten Frost","doi":"10.1210/clinem/dgaf245","DOIUrl":"https://doi.org/10.1210/clinem/dgaf245","url":null,"abstract":"<p><strong>Objective: </strong>Muscle mass and function are impaired in T1D, however, the relevance to bone health is unknown. This study aimed to examine the relationship between muscle mass, muscle strength, and bone in adults with childhood onset of T1D.</p><p><strong>Methods: </strong>This cross-sectional study population includes 111 Danish men and women with T1D onset before 18 years of age and 37 sex- and age-matched controls. Lean mass was assessed through dual-energy x-ray absorptiometry (DXA), and hand grip strength was measured using a dynamometer. Bone mineral density (BMD), bone size, and bone material strength index (BMSi) were assessed by DXA, high-resolution peripheral quantitative Computed Tomography (HR-pQCT), and microindentation.</p><p><strong>Results: </strong>Participants had a median age of 43.2 years and BMI of 26.9 kg/m², with no differences between groups. Total and appendicular lean mass were comparable in persons with and without T1D (p = 0.41 and p = 0.75), as was grip strength (p = 0.52). BMD, bone size (cortical area and perimeter), and BMSi did not differ between groups (p > 0.05). Within the T1D group, ALM/height2 was positively associated with femoral neck (FN) BMD (R2 = 0.12) and total hip (TH) BMD (R2 = 0.337). Similarly, grip strength was associated with FN-BMD (R2 = 0.104), and TH-BMD (R2 = 0.137). The associations between muscle indices and BMD measures did not differ significantly between groups.</p><p><strong>Conclusion: </strong>We observed a strong association between muscle and bone regardless of T1D status. Overall, the associations did not differ between the T1D and control groups, suggesting that the muscle-bone crosstalk is not affected by T1D.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062596","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":"Development and validation of a diabetes risk prediction model with individualized preventive intervention effects.","authors":"Byron Jaeger, Ramon Casanova, Yitbarek Demesie, Jeanette Stafford, Brian Wells, Michael P Bancks","doi":"10.1210/clinem/dgaf250","DOIUrl":"https://doi.org/10.1210/clinem/dgaf250","url":null,"abstract":"<p><strong>Objective: </strong>Type 2 diabetes risk prediction models lack the option to predict risk conditional on initiating different preventive interventions. Our objective was to develop and validate a diabetes risk prediction model with individualized preventive intervention effects among racially diverse populations.</p><p><strong>Methods: </strong>The derivation cohort included participants in the Diabetes Prevention Program (DPP) trial randomized to placebo, metformin, or intensive lifestyle intervention (N=2640). A risk prediction model for incident diabetes was developed using Cox proportional hazards regression using clinically available predictors: sex, glycated hemoglobin, fasting plasma glucose (FPG), body mass index (BMI), triglycerides, and intervention. To create individualized intervention effects, pairwise interactions between intervention and age, FPG, and BMI were included. The discrimination, calibration, and net benefit of the model's 3-year predictions for incident diabetes were internally validated within the DPP and externally validated among participants with prediabetes in the Multi-Ethnic Study of Atherosclerosis (MESA; N=2104).</p><p><strong>Results: </strong>In DPP and MESA, mean (standard deviation) age was 51 years (11) and 64 (10) and 67% and 50% of participants were women, respectively. The mean C-statistic was 0.71 (95% confidence interval [CI]: 0.68, 0.74) in DPP and 0.86 (95% CI: 0.83, 0.88) in MESA. The optimal preventive intervention (lowest 3-year risk) was lifestyle for 86% and 97% of DPP and MESA participants, respectively, and metformin for the remaining. Model performance was similar across race/ethnicity groups.</p><p><strong>Conclusion: </strong>This is the first study to develop and validate a diabetes risk prediction model with individualized preventive intervention effects which may improve clinical decision-making and diabetes prevention.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":""},"PeriodicalIF":5.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056291","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}