Endocrinology and metabolism (Seoul, Korea)最新文献

{"title":"Link between Circulating CCL2 Levels and Sarcopenia: Evidence from a Cohort Study, the UK Biobank, and Human GTEx Transcriptomic Data.","authors":"Mi Kyung Kwak, Sung-Jin Kim, So Jeong Park, Tam Dao, Ji Yeon Baek, Dongryeol Ryu, June Yeon Kim, Geon Young Jang, Eunju Lee, Hyuk Sakong, Yuna Lee, Eun-Gyoung Hong, Yunju Jo, Beom-Jun Kim","doi":"10.3803/EnM.2026.3058","DOIUrl":"https://doi.org/10.3803/EnM.2026.3058","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation is a hallmark of aging, but the role of inflammatory mediators such as C-C motif chemokine ligand 2 (CCL2) in skeletal muscle health remains unclear. Although CCL2 is often considered a detrimental pro-aging factor, it is also essential for myogenesis. This study aimed to clarify the complex role of CCL2 in human muscle metabolism.</p><p><strong>Methods: </strong>We used a multimodal approach integrating clinical, proteomic, transcriptomic, and genetic analyses. The association between circulating CCL2 and sarcopenia-related parameters was examined in 323 community-dwelling older adults and validated using UK Biobank data (n=54,219). Genotype-Tissue Expression (GTEx) transcriptomic data (n=818) were used for tissue-level analysis, and Mendelian randomization (MR) was performed to assess causality.</p><p><strong>Results: </strong>In the cohort study, serum CCL2 levels were significantly higher in participants with sarcopenia, weak muscle strength, or poor physical performance (P<0.001 to 0.042) and were inversely correlated with skeletal muscle index, grip strength, and gait speed (P<0.001 to 0.003). Each standard deviation increase in circulating CCL2 level was associated with 1.37-1.71-fold higher odds of sarcopenia-related outcomes (all P≤0.028). UK Biobank data also showed higher plasma CCL2 levels in participants with sarcopenia (P=0.005). In contrast to these observational findings, tissue-level analysis using GTEx data showed that higher skeletal muscle CCL2 expression was correlated with greater muscle cross-sectional area. MR further supported an inverse causal association between genetically predicted plasma CCL2 levels and sarcopenia risk (P=0.029).</p><p><strong>Conclusion: </strong>These divergent findings raise the possibility that elevated circulating CCL2 levels in sarcopenia reflect a compensatory response to muscle deterioration rather than a direct pathogenic driver, highlighting the need for further mechanistic validation.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global 30-Year Trajectory and Socioeconomic Disparities of Type 2 Diabetes Mellitus in Older Adults (1990-2021).","authors":"Feng Xie, Jigui Chen, Shaihong Zhu, Fei Xiong, Xulong Sun","doi":"10.3803/EnM.2025.2664","DOIUrl":"https://doi.org/10.3803/EnM.2025.2664","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is an escalating global health crisis among aging populations, warranting a comprehensive epidemiological assessment to support evidence-based policy development.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease Study 2021, we examined age-standardized rates of prevalence, incidence, mortality, and disability-adjusted life-years among populations aged ≥55 years from 1990 to 2021. Temporal patterns were quantified using estimated annual percentage change (EAPC). Decomposition analysis was used to identify drivers of burden change, and Bayesian age-period-cohort models were used to project trends through 2040.</p><p><strong>Results: </strong>Global T2DM cases among adults aged ≥55 years reached 305.6 million in 2021 (95% uncertainty interval, 282.3-331.7 million), representing a 244% increase since 1990. The age-standardized prevalence rate reached 19,298.52 per 100,000, with a sustained upward trajectory (EAPC: 1.217; 95% confidence interval, 1.172 to 1.262). Regional disparities were pronounced, ranging from 32,846.21 per 100,000 in North Africa and the Middle East to 10,400.58 per 100,000 in Eastern Sub-Saharan Africa. Males and populations in low-middle-income region experienced a disproportionately high burden. Risk factor analysis identified high body mass index as the dominant contributor (46.0%), followed by ambient particulate matter pollution (11.8%) and low physical activity (8.8%). Projections indicate continued increases in prevalence rates to 25,706.8 and 21,693.4 per 100,000 in men and women, respectively, by 2040.</p><p><strong>Conclusion: </strong>The T2DM burden among older adults has expanded dramatically, revealing substantial regional and socioeconomic disparities. These findings underscore the urgent need for evidence-based interventions targeting obesity prevention and age-specific healthcare frameworks.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiofrequency Ablation for Papillary Thyroid Carcinoma versus Surgery and Other Thermal Ablation Techniques: A Systematic Review and Meta-Analysis of Outcomes.","authors":"Eun Ju Ha, Min Kyoung Lee, Jeong Hoon Lee, Ji Ye Lee, Ji-Hoon Kim","doi":"10.3803/EnM.2026.2976","DOIUrl":"https://doi.org/10.3803/EnM.2026.2976","url":null,"abstract":"<p><strong>Background: </strong>Radiofrequency ablation (RFA) has been proposed for selected patients with low-risk papillary thyroid carcinoma (PTC). This study compared the effectiveness, safety, and procedural characteristics of RFA with those of surgery and other thermal ablation techniques.</p><p><strong>Methods: </strong>PubMed, Embase, Cochrane, and KoreaMed were searched for studies published between January 2000 and March 2025. Two reviewers independently extracted data in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed study quality using the Risk of Bias Assessment Tool for Nonrandomized Studies, version 2. Pooled analyses were performed using random-effects models. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes, and mean differences (MDs) were calculated for continuous outcomes.</p><p><strong>Results: </strong>Fifteen studies including 3,612 patients with PTC were analyzed. Compared with surgery, RFA was associated with a similar disease progression rate (OR, 0.91; 95% CI, 0.55 to 1.51; P=0.683) and a lower complication rate (OR, 0.35; 95% CI, 0.20 to 0.63; P=0.003). RFA was also associated with less intraoperative blood loss (MD, -21.87 mL), shorter procedure time (MD, -68.14 minutes), and shorter hospital stay (MD, -5.75 days; all P<0.001). Compared with other thermal ablation techniques, RFA showed similar disease progression rates (OR, 1.05; 95% CI, 0.16 to 7.14), complication rates (OR, 0.88; 95% CI, 0.17 to 4.49), volume reduction rates (MD, 0.02%), and complete disappearance rates (MD, 0.96%), with no statistically significant differences across outcomes.</p><p><strong>Conclusion: </strong>RFA may be considered as an alternative to surgery for selected patients with low-risk PTC. Randomized trials with longer follow-up are needed to confirm its oncologic durability and safety.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Clinicopathologic Characteristics of Pediatric Differentiated Thyroid Carcinoma: A Single-Center Experience from 1995 to 2022.","authors":"Hyunju Park, Jung Heo, Hyun Jin Ryu, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung","doi":"10.3803/EnM.2025.2762","DOIUrl":"https://doi.org/10.3803/EnM.2025.2762","url":null,"abstract":"<p><strong>Background: </strong>The incidence of pediatric differentiated thyroid carcinoma (DTC) has increased, but temporal trends in its clinicopathologic features remain unclear. We evaluated changes in the clinicopathologic features and treatment trends of pediatric DTC from 1995 to 2022.</p><p><strong>Methods: </strong>This study included 168 pediatric DTC patients treated at Samsung Medical Center, Korea. The patients were grouped according to the year of initial surgery: Period 1 (1995-2005), Period 2 (2006-2010), Period 3 (2011-2015), and Period 4 (2016-2022). The primary outcome was recurrence-free interval.</p><p><strong>Results: </strong>Age at diagnosis, primary tumor size, Tumor-Node-Metastasis (TNM) stage, and route of detection did not differ across periods. However, the distribution of American Thyroid Association (ATA) risk categories shifted toward lower-risk disease (P for trend=0.041), and the incidence of diffuse sclerosing variant papillary thyroid carcinoma (DSV-PTC) increased (P for trend=0.003). Additionally, the extent of surgery decreased (P for trend <0.001), and radioactive iodine (RAI) therapy was administered less frequently over time (P for trend <0.001). Among patients who received RAI therapy, cumulative dose within 2 years after surgery significantly decreased (P for trend=0.005), particularly in the ATA low- and intermediate-risk groups. DSV-PTC, and the ATA highrisk group were significant predictors of disease recurrence. However, the diagnostic era was not significantly associated with disease recurrence (log-rank P=0.468).</p><p><strong>Conclusion: </strong>In this single-center cohort study, age at diagnosis, primary tumor size, TNM stage, and route of detection remained consistent over time; however, the proportion of DSV-PTC increased. Treatment strategies shifted toward more conservative approaches, especially in low- and intermediate-risk groups.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary 18-Hydroxycortisol as a Noninvasive Marker for Lateralization in Primary Aldosteronism.","authors":"Seung Shin Park, Soyeon Park, Man Ho Choi, Jung Hee Kim","doi":"10.3803/EnM.2026.3092","DOIUrl":"https://doi.org/10.3803/EnM.2026.3092","url":null,"abstract":"<p><strong>Background: </strong>Accurate subtyping of primary aldosteronism (PA) is necessary for selecting treatment, but adrenal venous sampling (AVS) is invasive and technically demanding. Plasma and urinary hybrid steroids, including 18-hydroxycortisol (18-OHF) and 18-oxocortisol, have been used to predict PA lateralization; however, whether salivary steroid measurements can provide similar diagnostic information remains unclear.</p><p><strong>Methods: </strong>Six salivary steroids, including 18-OHF, were measured by liquid chromatography-mass spectrometry in 74 patients with confirmed PA who underwent AVS. The ability of salivary steroid markers to predict AVS-confirmed lateralized PA was evaluated using receiver operating characteristic analysis, net reclassification improvement (NRI), and integrated discrimination improvement (IDI), with the aldosterone-to-renin ratio (ARR) used as the reference model.</p><p><strong>Results: </strong>Among the salivary steroids evaluated, only 18-OHF was significantly higher in patients with lateralized PA (n=38) than in those with bilateral disease (n=36) (median 0.66 ng/mL vs. 0.25 ng/mL, P<0.001). Salivary 18-OHF showed moderate discrimination for lateralization (area under the curve [AUC], 0.749; 95% confidence interval [CI], 0.633 to 0.866), similar to ARR. Adding salivary 18-OHF to ARR produced only a small increase in AUC, but reclassification analyses showed significant improvement (overall NRI, 0.684; P=0.006; IDI, 0.126; P=0.002), mainly through correct downward reclassification of patients without lateralized disease. Salivary 18-OHF correlated strongly with serum 18-OHF and performed comparably to serum 18-OHF in predicting lateralization.</p><p><strong>Conclusion: </strong>Salivary 18-OHF may be a noninvasive marker for predicting lateralization in PA. Its addition to ARR improved risk reclassification, particularly by identifying patients less likely to have lateralized disease, and may therefore help refine stepwise diagnostic pathways that determine which patients proceed to AVS.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ezetimibe Treatment Is Associated with Lower Risk of Incident Cancer: A Nationwide Population-Based Cohort Study.","authors":"Yongin Cho, Hye-Sun Park, Min-Ae Park, Sojeong Park, Da Hea Seo, Seong Hee Ahn, Seongbin Hong, So Hun Kim","doi":"10.3803/EnM.2025.2615","DOIUrl":"https://doi.org/10.3803/EnM.2025.2615","url":null,"abstract":"<p><strong>Background: </strong>Ezetimibe has demonstrated favorable outcomes, including a reduction in cardiovascular complications and improvement in insulin resistance. However, its association with cancer risk remains unclear. This study evaluated the association between the use of ezetimibe-statin combination therapy and cancer risk using real-world data.</p><p><strong>Methods: </strong>Korean National Health Insurance Service database health records were analyzed using propensity score matching to compare the cancer-related outcomes between ezetimibe-statin combination therapy and statin monotherapy groups. Outcomes included cancer incidence, cancer-specific mortality, and all-cause mortality.</p><p><strong>Results: </strong>In a cohort of 669,036 statin users, ezetimibe-statin combination therapy was associated with a significantly lower risk of cancer (hazard ratio [HR], 0.89; P<0.001) and cancer-related mortality (HR, 0.85; P<0.001) compared with statin monotherapy. Combination therapy was also associated with a lower risk of specific cancers, including colorectal, liver, breast, pancreatic, and biliary tract cancers. These inverse associations were consistent across subgroups stratified according to age, sex, alcohol consumption/smoking history, and the presence of diabetes or hypertension (all P for interaction >0.05). Moreover, a longer duration of ezetimibe use was linked to a lower cancer risk, with the most pronounced inverse associations observed in individuals who had used the drug for ≥4 years.</p><p><strong>Conclusion: </strong>These findings suggest that ezetimibe combined with statins may be associated with a reduced risk of cancer.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148877244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The C-Reactive Protein-Triglyceride Glucose Index and Incidence of Cardiovascular Disease Among Individuals with Hypertension: A Nationwide Prospective Cohort Study.","authors":"Yin Wang, Jie Luo, Zhaofu Tan, Xiaodong Li, Lifu Sun, Xiang Qu, Genlong Bai, Yidian Fu, Jingbo Zhang","doi":"10.3803/EnM.2026.2958","DOIUrl":"https://doi.org/10.3803/EnM.2026.2958","url":null,"abstract":"<p><strong>Background: </strong>The C-reactive protein-triglyceride glucose index (CTI) has recently been introduced as a novel composite biomarker that integrates inflammation and insulin resistance. However, the association between CTI and incident cardiovascular disease (CVD) in individuals with hypertension remains unclear.</p><p><strong>Methods: </strong>We included 168,186 participants from the UK Biobank in this longitudinal analysis. The primary outcomes were incident coronary heart disease (CHD), atrial fibrillation (AF), heart failure (HF), and stroke. Cox proportional hazards regression was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between CTI and incident CVD outcomes.</p><p><strong>Results: </strong>In this study, CTI showed significant positive linear associations with CHD (HR, 1.19; 95% CI, 1.15 to 1.23) and stroke (HR, 1.14; 95% CI, 1.07 to 1.21), whereas nonlinear associations were observed for AF (HR, 1.08; 95% CI, 1.04 to 1.13) and HF (HR, 1.36; 95% CI, 1.28 to 1.44) among participants with hypertension. Furthermore, subgroup and sensitivity analyses confirmed the robustness of these associations.</p><p><strong>Conclusion: </strong>Our findings showed that elevated CTI levels were robustly associated with increased risks of CHD, AF, HF, and stroke, suggesting that CTI may serve as a promising predictive marker for CVD in individuals with hypertension.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148687605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"WITHDRAWN: Obesity and Bone Fragility: The Hidden Impact of Insulin Resistance on Trabecular Bone Score, Not Bone Density.","authors":"Taehoon Park, Kyungwon Seo, Ki Hyun Kim, Yoonhong Kim, Bukyung Kim","doi":"10.3803/EnM.2025.2556","DOIUrl":"10.3803/EnM.2025.2556","url":null,"abstract":"<p><p>Ahead of Print article withdrawn by publisher.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenic Obesity Is Associated with High Insulin Resistance and New-Onset Diabetes Following Pancreaticoduodenectomy.","authors":"Won-Gun Yun, Youngmin Han, Yoon Soo Chae, Young Jae Cho, Hye-Sol Jung, Wooil Kwon, Jin-Young Jang, Joon Seong Park","doi":"10.3803/EnM.2025.2859","DOIUrl":"https://doi.org/10.3803/EnM.2025.2859","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenic obesity, characterized by reduced skeletal muscle mass accompanied by excessive visceral fat accumulation, has recently gained attention as a crucial determinant of metabolic dysfunction. Although pancreaticoduodenectomy (PD) is increasingly performed with improved surgical outcomes, the incidence and risk factors for new-onset diabetes after PD remain incompletely understood. This study investigated the impact of sarcopenic obesity on postoperative glucose metabolism.</p><p><strong>Methods: </strong>A total of 613 patients without preexisting diabetes who underwent PD between 2015 and 2023 were retrospectively analyzed. Diabetes status was evaluated preoperatively and at 3 months postoperatively (Cohort 1), and a subset of 143 patients was reassessed at 1 year (Cohort 2). Sarcopenic obesity was defined as a visceral fat area/skeletal muscle index >2.5 m2. Diabetes was defined according to the American Diabetes Association criteria.</p><p><strong>Results: </strong>At 3 months after surgery, 8.2% (50/613) of patients developed diabetes. Independent predictors included hypertension (odds ratio [OR], 2.45), elevated preoperative hemoglobin A1c (OR, 2.31), and receipt of adjuvant chemotherapy (OR, 3.15). At 1 year, 9.8% (14/143) developed diabetes, with sarcopenic obesity emerging as the sole independent predictor (OR, 3.65; 95% confidence interval, 1.09 to 14.43). Additionally, patients with sarcopenic obesity had significantly higher levels of hemoglobin A1c, Cpeptide, and insulin resistance 1 year after surgery than those without sarcopenic obesity.</p><p><strong>Conclusion: </strong>Sarcopenic obesity was associated with persistent postoperative insulin resistance. These findings suggest that sarcopenic obesity constitutes a key determinant of new-onset diabetes after PD and highlight the need for preoperative assessment and targeted metabolic interventions in this high-risk population.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular Health Protects against Thyroid Dysfunction: Findings from the UK Biobank.","authors":"Jilong Bai, Rui Ren, Panting Wei, Yao Zhang, Liying Wang, Wenxu Wang, Wan Yu, Difei Wang","doi":"10.3803/EnM.2025.2722","DOIUrl":"https://doi.org/10.3803/EnM.2025.2722","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated the association between cardiovascular health (CVH) and thyroid dysfunction, and the modifying role of depression or anxiety remains unclear.</p><p><strong>Methods: </strong>This longitudinal study included 360,332 UK Biobank participants without thyroid disease at baseline and with complete CVH scores. We examined the associations between CVH and the risks of hyperthyroidism and hypothyroidism using Cox proportional hazards regression models, quantified the relative contributions of CVH components using weighted quantile sum regression, and evaluated the mediating role of inflammatory markers. Furthermore, we investigated the modifying effects of depression and anxiety on these associations. A multi-state model was used to explore disease trajectories.</p><p><strong>Results: </strong>During a median follow-up of 12.53 years, 1,533 and 7,542 participants developed hyperthyroidism and hypothyroidism, respectively. After multivariable adjustment, each 5-point increase in CVH score was associated with a 7% (95% confidence interval [CI], 4% to 9%) lower risk of hyperthyroidism and an 8% (95% CI, 7% to 9%) lower risk of hypothyroidism. A high CVH score was associated with a 50% (95% CI, 37% to 60%) lower risk of hyperthyroidism and a 45% (95% CI, 38% to 50%) lower risk of hypothyroidism. Among the CVH components, obesity and tobacco exposure contributed most to disease risk. Inflammatory markers partially mediated these associations. Depression and anxiety modified the association between CVH and hypothyroidism, and CVH showed a protective effect across the disease trajectories.</p><p><strong>Conclusion: </strong>Maintaining favorable CVH was associated with a lower risk of thyroid dysfunction, particularly among individuals with good mental health.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}