Journal of Clinical Endocrinology & Metabolism最新文献

{"title":"National Trends in US Hospitalizations and Outcomes of Thyrotoxicosis With and Without Thyrotoxic Storm, 2016 to 2020.","authors":"Fidelis Uwumiro, Emmanuel Arji, Victory Okpujie, Felix Asaju, Onyeka Egemonye, Nathaniel Eyiah, Ifeoluwa Falade, Ebube Anasiudu, Samuel Asogwa, Fadilat Gbajumo, Rosola Sule, Akosua Agyei, Franklin Andibanbang, Abdulfatai Makinde, Olayemi Akanmode","doi":"10.1210/clinem/dgaf150","DOIUrl":"10.1210/clinem/dgaf150","url":null,"abstract":"<p><strong>Context: </strong>Thyrotoxicosis, a potentially life-threatening endocrine disorder, can result in severe complications, particularly when it progresses to thyroid storm. Analyzing hospitalization trends, outcomes, and the healthcare burden associated with thyrotoxicosis is essential for enhancing management strategies and optimizing resource allocation.</p><p><strong>Objective: </strong>We analyzed trends in thyrotoxicosis hospitalizations with and without thyroid storm in the United States between 2016 and 2020.</p><p><strong>Methods: </strong>We analyzed data from the national inpatient database using International Classification of Diseases, Tenth Revision (ICD-10) codes for thyrotoxicosis (E05). We compared demographics using χ2 tests. Trends in hospitalization outcomes were assessed using the Cuzick test. Hospital costs were adjusted for inflation using the 2020 consumer price index. Odds of mortality and secondary outcomes were analyzed using multivariable logistic regression. Hospital stay in the 95th percentile was considered prolonged.</p><p><strong>Results: </strong>A total of 33 430 hospitalizations were analyzed. Hospitalization rates declined from 7444 in 2016 to 5424 in 2020 (Ptrend = .002). Mortality rates increased both for hospitalizations without storm (10 [0.17%] in 2016 to 55 [1.30%] in 2020; Ptrend < .001) and with thyroid storm (10 [0.62%] in 2016 to 50 [4.15%] in 2020; Ptrend = .051). There was an uptrend in prolonged hospitalization rates in the total study cohort (11.9% [3978] to 14.6% [4881]; Ptrend = .030). Total hospital costs increased from $36 408 to 49 031 (Ptrend < .001). A similar uptrend was observed with ($45 343 to $69 321; Ptrend < .001) and without storm ($34 066 to $42 703; Ptrend < .001). Thyroid storm was correlated with higher odds of major adverse cardiovascular events (adjusted odds ratio [aOR]: 1.05; 95% CI, 1.02-1.17; P = .002), including acute heart failure (aOR: 1.15; 95% CI, 1.03-1.78; P < .001), sudden cardiac death (aOR: 1.23; 95% CI, 1.04-2.17; P = .041), and atrial fibrillation (aOR: 1.17; 95% CI, 1.05-2.06; P < .001).</p><p><strong>Conclusion: </strong>In the present study, we examined trends in hospilization and outcomes of thyrotoxicosis across the United States. Hospitalization rates for thyrotoxicosis were reduced while mortality rates significantly increased. There was an uptrend in health care costs, prolonged hospitalization, and the incidence of MACEs.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"3084-3096"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606975","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":"The Efficacy and Safety of Denosumab for Treating Hypercalcemia in Primary Hyperparathyroidism: A Retrospective Study.","authors":"An Song, Yingyu Chen, Rong Chen, Shuzhong Liu, Liyuan Kou, Jiajia Wang, Min Nie, Yan Jiang, Mei Li, Weibo Xia, Xiaoping Xing, Ou Wang","doi":"10.1210/clinem/dgaf107","DOIUrl":"10.1210/clinem/dgaf107","url":null,"abstract":"<p><strong>Context: </strong>Denosumab is approved for treating hypercalcemia of malignancy, but data on its efficacy for hypercalcemia related to primary hyperparathyroidism (PHPT) are limited.</p><p><strong>Objective: </strong>To compare the efficacy and safety of denosumab with zoledronic acid in PHPT-related hypercalcemia.</p><p><strong>Methods: </strong>We retrospectively collected data from 29 PHPT patients with moderate/severe hypercalcemia (corrected serum calcium [CSC] ≥ 3.0 mmol/L) treated with denosumab (60 or 120 mg; Dmab group) and CSC-matched 29 PHPT patients treated with zoledronic acid (4 mg; ZA group). The primary efficacy outcome was the change of CSC (ΔCa), while secondary outcomes included the response proportion, time to response, and duration of response. Safety data were also collected.</p><p><strong>Results: </strong>Both groups showed significant reductions in CSC levels (Dmab: 3.37 ± 0.37 mmol/L to 2.64 ± 0.33 mmol/L,   P < .01; ZA: 3.41 ± 0.32 mmol/L to 2.57 ± 0.23 mmol/L, P < .01), with similar ΔCa. In the Dmab group, 82.8% (24/29) responded with CSC levels below 3.0 mmol/L, and 72.4% (21/29) achieved complete response (CR, serum CSC less than 2.7 mmol/L), comparable to the ZA group. The time to CR was shorter for ZA (3.0 vs 7.0 days, P < .01), while Dmab had a longer duration of response (19.0 vs 13.0 days, P = .02). Hypocalcemia occurred in 6.9% (2/29, both with chronic kidney disease stage 3b) of Dmab patients, while none in the ZA group.</p><p><strong>Conclusion: </strong>A single 60-mg dose of denosumab effectively reduces serum calcium levels in PHPT patients with moderate/severe hypercalcemia, at least maintaining efficacy for a median of nearly 3 weeks without serious adverse events.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3756-e3767"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558042","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 PTH 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":"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 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 3 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. Twenty-four-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>Conclusion: </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":"e3694-e3700"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","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":"Adult Growth Hormone Deficiency, Replacement Therapy, and Outcomes in Long-Term Childhood Cancer Survivors.","authors":"Tomoko Yoshida, Jessica L Baedke, Huiqi Wang, Yan Chen, Christine Yu, Carmen L Wilson, Daniel A Mulrooney, Stephanie B Dixon, I Chan Huang, Tara M Brinkman, Kevin R Krull, Sogol Mostoufi-Moab, José Miguel Martínez, Kirsten K Ness, Melissa M Hudson, Yutaka Yasui, Angela Delaney","doi":"10.1210/clinem/dgaf156","DOIUrl":"10.1210/clinem/dgaf156","url":null,"abstract":"<p><strong>Context: </strong>The consequences of untreated adult growth hormone deficiency (aGHD) among childhood cancer survivors are not well defined. The lack of evidence and socioeconomic factors may contribute to underutilization of growth hormone therapy (GHT) among survivors with aGHD.</p><p><strong>Objectives: </strong>This work aimed to examine the association of GHT use with socioeconomic factors and to assess the effect of untreated aGHD in survivors using insulin-like growth factor-1 (IGF1) as a marker of GH action.</p><p><strong>Methods: </strong>A total of 3902 five-year survivors of childhood cancer aged 18 years and older were included. The associations between GHT use and socioeconomic factors (health insurance coverage, income, area deprivation index), and associations between IGF1 levels and prevalences of adverse physical, neurocognitive, and psychosocial outcomes were assessed cross-sectionally by multivariable logistic regression adjusting for potential confounders.</p><p><strong>Results: </strong>Among 354 survivors with severe aGHD, 9.0% were on GHT. Socioeconomic disadvantages were independently associated with less use of GHT (eg, odds ratio [OR] of GHT use 0.27; 95% CI, 0.08-0.84 for annual household income <$40 000 vs ≥$80 000). The low IGF1 group (z score ≤ -2) experienced significantly higher prevalences of various adverse outcomes compared to the normal IGF1 group (z score >0), including various neurocognitive impairment (eg, verbal reasoning [OR 2.79; 95% CI, 1.95-3.98]), diminished health-related quality of life (eg, physical functioning [1.97; 1.35-2.86]), abnormal glucose metabolism (1.82; 1.21-2.71), and abnormal fat percentage (3.16; 1.98-5.26).</p><p><strong>Conclusion: </strong>Untreated aGHD potentially contributes to multidimensional adverse outcomes, and GHT may provide health benefits among survivors, though socioeconomic disadvantage may limit their access to GHT.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3673-e3684"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582393","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":"Etiology and Clinical Features of Patients With Hyponatremia in the Emergency Department: A Cross-sectional Study.","authors":"Tetsuya Kawahara, Mikio Toda, Maiko Kanagawa, Nagahiro Toyama, Chie Kawahara, Tetsuya Inazu","doi":"10.1210/clinem/dgaf192","DOIUrl":"10.1210/clinem/dgaf192","url":null,"abstract":"<p><strong>Objective: </strong>Hyponatremia, a common electrolyte disorder, affects a significant portion of the population, particularly in emergency and hospitalized settings. This study aimed to investigate the causes and clinical characteristics of hyponatremia in emergency department patients.</p><p><strong>Methods: </strong>This cross-sectional study included 997 patients diagnosed with hyponatremia in the emergency department between June 2019 and May 2024. We investigated the causes of hyponatremia through medical interviews, blood tests, and urinalysis.</p><p><strong>Results: </strong>We found that for every 1-year increase in age, serum sodium levels in patients with hyponatremia decreased by 0.14 mmol/L, whereas for every 1 mg/dL increase in serum uric acid, the serum sodium levels increased by 0.125 mmol/L. The leading cause of hyponatremia was the syndrome of inappropriate antidiuresis (SIAD), accounting for 357 cases (35.8%). However, a significant number of patients showed a similar diagnostic pattern to that of SIAD but were diagnosed with other conditions, such as cerebral salt wasting (31 cases, 5.8%), renal salt wasting (23 cases, 3.8%), and mineralocorticoid-responsive hyponatremia of the elderly (17 cases, 1.8%). Many patients initially diagnosed with SIAD were later found to have 1 of these alternative conditions upon further evaluation. Fractional excretion values of phosphate and uric acid effectively distinguished SIAD from other conditions.</p><p><strong>Conclusion: </strong>Hyponatremia in the emergency department has diverse causes, with overlapping diagnostic criteria for SIAD and related conditions, though treatment strategies vary significantly. Accurate differential diagnosis is crucial to optimizing patient outcomes. Recognizing the range of underlying causes can help clinicians improve treatment strategies for hyponatremia in emergency settings.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"3025-3033"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701531","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":"Degree of Joint Risk Factor Control and Incident Fracture Outcomes in Individuals With Type 2 Diabetes.","authors":"Huan Huang, Jie Cai, Huaying Hu, Lishan Cai, Lu Qi, Tao Zhou","doi":"10.1210/clinem/dgaf172","DOIUrl":"10.1210/clinem/dgaf172","url":null,"abstract":"<p><strong>Context: </strong>Individuals with type 2 diabetes have a higher fracture risk than the general population. However, the association between joint risk factor control and fracture risk in this population remains unclear.</p><p><strong>Objective: </strong>To investigate the extent to which joint risk factor control might attenuate the excess risk of fracture outcomes in individuals with type 2 diabetes.</p><p><strong>Methods: </strong>We included 8935 individuals with type 2 diabetes and 35 740 matched controls without fractures at baseline from the UK Biobank (UKB), with a median follow-up of 12.1 years. Six modifiable risk factors were assessed: body mass index (BMI), physical activity, smoking, alcohol consumption, serum 25-hydroxyvitamin D (25(OH)D), and glycated hemoglobin A1c (HbA1c). Cox proportional hazards models were used to estimate associations between risk factor control and fracture risk.</p><p><strong>Results: </strong>Controlling each additional risk factor resulted in a 14% to 26% decrease in fracture risk. Optimal control (≥5 risk factors) correlated with a 50% reduction in overall fractures (HR 0.50; 95% CI 0.33-0.75). However, a 60% reduction in hip fractures (HR 0.40; 95% CI 0.16-0.98) was observed with the control of 4 risk factors. With control of 4 or more risk factors, fracture risk in individuals with type 2 diabetes was comparable to that of nondiabetic controls, and the protective effect was stronger in men than in women.</p><p><strong>Conclusion: </strong>Joint risk factor control was significantly linked to a reduced fracture risk, and optimal management may eliminate the excess fracture risk associated with type 2 diabetes.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3626-e3634"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626723","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":"Efficacy and Hypoglycemia Profile of Once-weekly Insulin Icodec vs Once-daily Comparators Across Demographic Subgroups.","authors":"Ildiko Lingvay, Julie Krogsdahl Bache, Cyrus V Desouza, Mariana Fragão-Marques, Andrea Navarria, Shehla S Shaikh, André G D Vianna","doi":"10.1210/clinem/dgaf168","DOIUrl":"10.1210/clinem/dgaf168","url":null,"abstract":"<p><strong>Objective: </strong>This post hoc analysis evaluated the impact of age, ethnicity, and race on efficacy and hypoglycemia outcomes with once-weekly insulin icodec (icodec) vs once-daily (OD) basal insulin comparators, leveraging data from the ONWARDS 1 to 5 phase 3a clinical trials.</p><p><strong>Methods: </strong>Efficacy and hypoglycemia outcomes were assessed within each trial in insulin-naive (ONWARDS 1, 3, and 5) and insulin-experienced (ONWARDS 2 and 4) adults (≥18 years) with type 2 diabetes across subgroups of age (<55, 55-64, and ≥65 years), ethnicity (Hispanic/Latino and non-Hispanic/Latino), and race (Asian, Black/African American, White, Other). The primary outcome was the change in glycated hemoglobin (HbA1c) from baseline to planned end of treatment. Other outcomes assessed included the achievement of HbA1c <7% (<53 mmol/mol) without clinically significant or severe hypoglycemia and the number of clinically significant or severe hypoglycemic episodes.</p><p><strong>Results: </strong>Across all trials, the estimated treatment differences for change in HbA1c and the odds ratios for achieving HbA1c <7% (<53 mmol/mol) without clinically significant or severe hypoglycemia were similar across age, ethnicity, and race subgroups with icodec vs OD insulin (no statistically significant treatment by subgroup interactions were observed; P > .05 in all instances). Hypoglycemia rates were numerically low for both treatment groups and consistent across age, ethnicity, and race subgroups.</p><p><strong>Conclusion: </strong>The efficacy and hypoglycemia profile of icodec vs OD comparators was consistent across trial populations irrespective of age, ethnicity, or race.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3596-e3606"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659400","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":"Reference Intervals for 24-Hour Urinary Calcium Excretion and Its Association With Bone Metabolism: A Multicenter Study.","authors":"Li Shen, Hao Zhang, Qi Lu, Shanshan Li, Yazhao Mei, Chao Gao, Hua Yue, Xiangtian Yu, Qi Yao, Yanan Huo, Yuhong Zeng, Yin Jiang, Zhongjian Xie, Aijun Chao, Xiaolan Jin, Guangjun Yu, Li Mao, Zhenlin Zhang","doi":"10.1210/clinem/dgae805","DOIUrl":"10.1210/clinem/dgae805","url":null,"abstract":"<p><strong>Context: </strong>The 24-hour urinary calcium excretion (UCaE) not only serves as an important indicator of calcium metabolism balance but also correlates with metabolic diseases. However, the distribution of 24-hour UCaE and its relationship with bone metabolism are unknown.</p><p><strong>Objective: </strong>To investigate the distribution of 24-hour UCaE and its association with bone metabolism.</p><p><strong>Methods: </strong>In this multicenter cross-sectional study, 1239 participants underwent physical examinations at 9 tertiary hospitals. Multivariate linear regression was used to explore bone metabolism associated with 24-hour UCaE. The relationship of bone metabolism with 24-hour urinary calcium excretion/urinary creatinine (UCaE/Ucr) was analyzed by using restrictive cubic splines fitting multiple linear regression model.</p><p><strong>Results: </strong>The 24-hour UCaE median range was 2.27 mmol overall, 2.24 mmol in men, and 2.28 mmol in women. For men, the highest 24-hour UCaE/Ucr was observed in those aged between 30 and 44 years (median: 0.70), whereas the lowest was found aged between 18 and 29 years (median: 0.46). For women, the 24-hour UCaE/Ucr showed a gradual increase with advancing age. In the adjusted model, 24-hour UCaE/Ucr was independently positively associated with 25(OH)D in both men (P = .032) and women (P < .001). It was independently associated with parathyroid hormone (PTH) (P = .031), type Ⅰ collagen-containing cross-linked C-telopeptide (β-CTX) (P = .021) and procollagen type I N-propeptide (P1NP) (P = .048) in men, but not in women. The prevalence of hypercalciuria was 11.6% (men 7.5%; women 14.0%) and significantly varied across age groups and regions (P < .05).</p><p><strong>Conclusion: </strong>This study established reference intervals for 24-hour UCaE in the Chinese population. This study found gender differences in the relationship between 24-hour UCaE and bone metabolism.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3783-e3793"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558698","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":"Adverse Cardiometabolic Outcomes in Men With Sisters With Polycystic Ovary Syndrome.","authors":"Aleksandra Kanina, Elisabet Stener-Victorin, Agnieszka Butwicka, Anna Sara Öberg, Mina A Rosenqvist, Carolyn E Cesta","doi":"10.1210/clinem/dgaf121","DOIUrl":"10.1210/clinem/dgaf121","url":null,"abstract":"<p><strong>Aims: </strong>Smaller clinical studies report risks of cardiometabolic dysfunction in brothers of women with polycystic ovary syndrome (PCOS). We aim to investigate the risk of adverse cardiometabolic outcomes in men with a sister with PCOS in a large longitudinal population-based cohort.</p><p><strong>Methods: </strong>Men born in Sweden (1973-2013) with ≥1 sister were followed from age 5 until 31 December 2018 (n = 1 098 203) and potential PCOS diagnoses in sisters identified. Risk of a clinical diagnosis of obesity, type 2 diabetes, or hypertension was estimated using Cox regression. In a subcohort, the association between categories of body mass index and blood pressure measured at age 18 to 20 years were estimated using logistic regression. Analyses were adjusted for birth year and parental education.</p><p><strong>Results: </strong>Men with a sister with PCOS had an increased risk of obesity [adjusted hazard ratio (aHR): 2.02; 95% confidence interval (CI) 1.85-2.21], type 2 diabetes (aHR: 1.62; 95% CI: 1.34-1.96), and hypertension (aHR: 1.24; 95% CI: 1.08-1.43), compared to men with unaffected sisters. In the subcohort evaluated at age 18 to 20 (n = 147 802), having a sister with PCOS (n = 2970) was associated with being overweight [adjusted odds ratio (aOR): 1.33; 95% CI: 1.19-1.49] and obese (aOR: 1.78; 95% CI: 1.47-2.15) but not elevated blood pressure.</p><p><strong>Conclusion: </strong>Having a sister with PCOS is associated with adverse cardiometabolic outcomes in men, already in early adulthood. Results contribute further knowledge on the familial impact of PCOS and highlight a patient group who may benefit from early screening and prevention.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"e3810-e3817"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558679","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":"Immune Dysregulation and Endometrial Receptivity Impairment in Women With Repeated Implantation Failure and Dyslipidemia.","authors":"Yuan Zhang, Xiaoya Sun, YuanYuan Zhang, Yangyun Zou, Yue Zhang, Jie Wang, Li Gao, Wei Ding, Feiyang Diao, Jiayin Liu, Joanne Young Hee Kwak-Kim, Xiang Ma","doi":"10.1210/clinem/dgaf100","DOIUrl":"10.1210/clinem/dgaf100","url":null,"abstract":"<p><strong>Context: </strong>Dyslipidemia adversely affects reproduction outcomes; however, its relation with repeated implantation failure (RIF) remains unclear.</p><p><strong>Objective: </strong>This study aims to analyze the impact of dyslipidemia on assisted reproductive technology (ART) outcomes, endometrial transcriptome, and microbiome of RIF women.</p><p><strong>Design: </strong>A retrospective real-world analysis and prospective study.</p><p><strong>Setting: </strong>University clinic.</p><p><strong>Patients: </strong>6499 infertile women, including 5618 non-RIF and 881 RIF.</p><p><strong>Interventions: </strong>Dyslipidemia.</p><p><strong>Main outcome measures: </strong>Implantation rate (IR), clinical pregnancy rate (CPR), and live birth rate (LBR) were compared in RIF women with or without dyslipidemia. Results of endometrial studies, including RNA sequencing (RNA-seq)-based endometrial receptivity test (ERT), 16S rRNA-based microbiome study, next-generation sequencing (NGS)-based gene comparison, and bulk RNA-seq deconvolution analysis were analyzed.</p><p><strong>Results: </strong>The prevalence of dyslipidemia in RIF women was significantly higher. In dyslipidemia women, IR, CPR, and LBR were significantly lower, and the prevalence of nonreceptive ERT and the presence of endometrial pathogenic bacteria were higher than those of controls. After the personalized treatment, CPR 73.3% and LBR 60.0% were achieved in dyslipidemia women. NGS revealed that 176 differentially expressed genes in the endometrium of RIF women with dyslipidemia compared to those without, suggesting highly enriched in cholesterol and steroid biosynthesis and monocyte differentiation processes. An increased endometrial CD56dim natural killer cells and macrophage M1/M2 ratio with dysregulated immune factors were found by bulk RNA-seq deconvolution analysis.</p><p><strong>Conclusion: </strong>RIF women with dyslipidemia have significantly poorer ART outcomes. In women with dyslipidemia, immune homeostasis was breached in the luteal phase endometrium, implicating a possible immune mechanism for dyslipidemia-related implantation failure.</p>","PeriodicalId":50238,"journal":{"name":"Journal of Clinical Endocrinology & Metabolism","volume":" ","pages":"3230-3242"},"PeriodicalIF":5.1,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469678","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}