Endocrinology and metabolism (Seoul, Korea)最新文献

{"title":"SGLT2 Inhibitors as Systemic Metabolic Modulators: Linking Glucose Excretion to Liver Function Restoration.","authors":"Seung Wan Noh, Han Sol Ryu, Yong-Ho Kim, Byung-Chul Oh","doi":"10.3803/EnM.2025.2786","DOIUrl":"10.3803/EnM.2025.2786","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as paradigm-shifting therapeutics that extend beyond glycemic regulation, to conferring profound hepatometabolic benefits. This review delineates the multifaceted mechanisms underlying metabolic dysfunction-associated steatotic liver disease (MASLD), with an emphasis on systemic metabolic remodeling, mitochondrial protection, and intracellular calcium restoration. By promoting glucosuria-induced energy depletion, SGLT2 inhibition alleviates insulin resistance, suppresses hepatic lipogenesis, and activates adenosine monophosphate-activated protein kinase (AMPK)-sirtuin 1 (SIRT1)-peroxisome proliferator-activated receptor γ (PPARγ) coactivator-1α pathways that reprogram hepatocellular metabolism toward achieving lipid oxidation and autophagy. Mechanistically, SGLT2 inhibitors restore intracellular Ca2+ homeostasis via sarcoplasmic/endoplasmic reticulum calcium ATPase 2 (SERCA2) activation, mitigating endoplasmic reticulum (ER) stress and normalizing Ca2+-phosphoinositide (PIP)-protein kinase B (AKT) signaling, collectively reinforcing insulin responsiveness and ER-mitochondrial crosstalk. Clinically, these effects translate into consistently reducing hepatic fat, aminotransferases, and fibrosis markers in both diabetic and nondiabetic patients with MASLD. Furthermore, SGLT2 inhibitors uniquely integrate renal energy regulation with hepatic resilience through the Ca2+-PIP-SERCA axis, positioning them as prototype systemic modulators of metabolic homeostasis. Future translational efforts should refine patient stratification using metabolomic and Ca2+-imaging biomarkers to delineate therapeutic responders and advance next-generation SGLT2 analogs targeting Ca2+-dependent metabolic signaling. Collectively, SGLT2 inhibitors represent a new metabolic therapeutic class that unify glucose, lipid, and Ca2+ regulation to restore hepatocellular functions in metabolic liver diseases.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":"40 6","pages":"851-865"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoporosis Management after the Occurrence of Medication-Related Osteonecrosis of the Jaw: A 13-Year Experience at a Tertiary Center.","authors":"Chun Ho Wong, Kimberly Hang Tsoi, Jingya Jane Pu, Nancy Su Jiang, Stacey Sheung Yi Chan, Connie Hong Nin Loong, Xincheng Zou, Carol Ho Yi Fong, Eunice Ka Hong Leung, Alan Chun Hong Lee, Chi Ho Lee, Kathryn Choon Beng Tan, Yu Cho Woo, Yu-Xiong Su, David Tak Wai Lui","doi":"10.3803/EnM.2024.2262","DOIUrl":"10.3803/EnM.2024.2262","url":null,"abstract":"<p><strong>Backgruound: </strong>We investigated osteoporosis management strategies and clinical outcomes following the occurrence of medicationrelated osteonecrosis of the jaw (MRONJ).</p><p><strong>Methods: </strong>We retrospectively studied individuals diagnosed with MRONJ during osteoporosis treatment who were managed in the Osteoporosis Center or the Oral Maxillofacial Surgery & Dental Unit at Queen Mary Hospital in Hong Kong between 2010 and 2022. We examined subsequent osteoporosis management plans, fracture events, and bone mineral density (BMD).</p><p><strong>Results: </strong>Thirty-six individuals were included (mean age, 78.5 years; 94.4% women). The estimated prevalence of MRONJ was 0.26%. All patients had been exposed to bisphosphonates, and seven had also received denosumab before MRONJ. Following MRONJ, only 14 individuals continued anti-osteoporosis treatment, a decision influenced by a higher fracture probability at MRONJ onset. The most common regimen was a teriparatide-raloxifene sequence (n=8): three patients achieved stable BMD, four achieved improving BMD, and one exhibited a mixed response. The patient with a mixed BMD response had also been treated with denosumab. Six patients sustained incident fractures after MRONJ, and these patients had lower BMD T-scores than their counterparts. Two patients experienced MRONJ recurrence, which was associated with the resumption of bisphosphonate or denosumab therapy after MRONJ. These patients had higher BMD T-scores than those who did not experience MRONJ recurrence.</p><p><strong>Conclusion: </strong>MRONJ is challenging because high fracture risk necessitates discontinuation of antiresorptive agents. Teriparatide followed by raloxifene may be a reasonable regimen. Individualised decisions in osteoporosis management after MRONJ are required to balance fracture risk reduction with minimising MRONJ recurrence.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"974-990"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LC‑MS/MS for Thyroglobulin: A Complementary Approach to Immunoassay Limitations for Thyroid Cancer.","authors":"Se Hee Park, Dong Yeob Shin","doi":"10.3803/EnM.2025.2822","DOIUrl":"10.3803/EnM.2025.2822","url":null,"abstract":"","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":"40 6","pages":"866-868"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete Blood Count Parameters and Bone Health: Clinical and Experimental Evidence.","authors":"Jeonghoon Ha, Mayo Ono, Hui Zhu, Caroline Cencer, Xiyu Ge, Joy Y Wu","doi":"10.3803/EnM.2025.2695","DOIUrl":"10.3803/EnM.2025.2695","url":null,"abstract":"<p><p>Osteoporotic fractures pose a significant burden in aging populations, yet current assessment strategies may overlook systemic factors influencing bone health. Emerging evidence suggests that complete blood count (CBC) parameters, including red blood cell indices, white blood cell (WBC) counts and subtypes, and platelet counts, are associated with skeletal fragility and fracture risk. Anemia has been consistently linked to reduced bone mineral density and increased fracture susceptibility, potentially due to impaired oxygen delivery and osteoblast dysfunction. Elevated red cell distribution width may reflect oxidative stress and has been associated with bone loss. Inflammatory markers such as high WBC count and neutrophil-to-lymphocyte ratio are implicated in enhanced osteoclast activity, while platelet abnormalities may influence bone remodeling and fracture healing. These associations suggest that CBC-derived markers could serve as accessible and cost-effective indicators to support osteoporosis evaluation. However, important limitations remain, including undefined clinical thresholds, limited longitudinal evidence, and uncertain causality. Further research is needed to clarify underlying mechanisms and determine whether correcting hematological abnormalities can improve skeletal outcomes. A cautious, evidence-based approach is warranted to define the role of CBC parameters in the clinical assessment of bone health.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"811-820"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145663460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty Liver Index Dynamics as a Predictor of Hepatocellular Carcinoma in Patients with Type 2 Diabetes Mellitus and Non-Cirrhotic Livers.","authors":"Eun-Hee Cho, Min Gu Kang, Chang Hun Lee, Shinyoung Oh, Chen Shen, Ha Ram Oh, Young Ran Park, Hyun Lee, Jong Seung Kim, Ji Hyun Park","doi":"10.3803/EnM.2024.2286","DOIUrl":"10.3803/EnM.2024.2286","url":null,"abstract":"<p><strong>Backgruound: </strong>Type 2 diabetes mellitus (T2DM) is a significant risk factor for hepatocellular carcinoma (HCC) in patients with nonalcoholic fatty liver disease; however, surveillance strategies for patients with T2DM, especially without cirrhosis, are inadequate. This study examined whether the fatty liver index (FLI) and its dynamic changes can effectively identify patients with T2DM at increased risk for HCC.</p><p><strong>Methods: </strong>Data from 92,761 individuals with T2DM aged 40 to 79 who underwent two health screenings (2012 to 2015) were analyzed. The FLI, calculated using waist circumference, body mass index, triglycerides, and gamma-glutamyl transferase, was used to stratify patients by baseline FLI and FLI changes between screenings. HCC cases were identified via International Classification of Diseases codes and reimbursement records (2016 to 2020).</p><p><strong>Results: </strong>Patients with baseline FLI of 30 to 59.9 had a 1.90-fold higher risk (P<0.01) and those with FLI ≥60 had a 2.94-fold higher risk (P<0.01) of developing HCC compared to those with FLI <30. An increase in FLI from <30 to ≥30 resulted in a 2.10-fold higher risk of HCC (P<0.01), while a reduction in FLI from ≥30 to <30 led to a 0.64-fold lower risk (P=0.03). Protective benefits of FLI reduction took approximately 3 years to manifest.</p><p><strong>Conclusion: </strong>Baseline and dynamic monitoring of FLI effectively identified HCC risk in T2DM patients with non-cirrhotic livers, supporting early detection and intervention.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"883-892"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Serum 25-Hydroxyvitamin D as a Risk Factor for Frailty in Community-Dwelling Older Men: A Korean Nationwide Study.","authors":"Jeongmin Lee, Min-Gu Kang, Jeonghoon Ha, Yunju Jo, Dongryeol Ryu, Hee-Won Jung, Ki-Hyun Baek, Beom-Jun Kim","doi":"10.3803/EnM.2025.2462","DOIUrl":"10.3803/EnM.2025.2462","url":null,"abstract":"<p><strong>Backgruound: </strong>Despite the critical role of vitamin D in various biological processes, its impact on frailty-a condition closely linked to biological age-remains inconclusive. This study aimed to explore the association between serum 25-hydroxyvitamin D (25[OH] D) levels and frailty status in older Korean adults, utilizing a comprehensive frailty index (FI) and a nationally representative dataset.</p><p><strong>Methods: </strong>This cross-sectional study included 6,589 participants aged ≥65 years from the Korea National Health and Nutrition Examination Survey (2008-2012). Frailty was assessed using a deficit accumulation FI based on 38 physical, cognitive, psychological, and social items.</p><p><strong>Results: </strong>After adjusting for potential confounders, frail men showed 6.8% lower serum 25(OH)D concentrations compared to nonfrail controls (P=0.007). Men in the lowest serum 25(OH)D quartile (≤39.3 nmol/L) exhibited a 5.3% higher FI (P=0.047) and 1.71-fold increased odds of frailty (P=0.005), compared to those in the highest quartile (>63.3 nmol/L). Similarly, men with vitamin D deficiency (<30 nmol/L) exhibited a 9.6% higher FI compared to those with sufficient vitamin D levels (≥50 nmol/L; P=0.004). However, no significant association between serum 25(OH)D concentration and frailty was observed in women across any analysis.</p><p><strong>Conclusion: </strong>These findings suggest that low serum 25(OH)D concentrations are a potential risk factor for frailty, particularly in men. Further research is warranted to determine whether vitamin D supplementation in such high-risk older adults could help mitigate frailty.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"961-973"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145461222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E): A Cohort Protocol for Dietary Iodine and Endocrine Disruptors.","authors":"Yun Ji Jung, Jeong Eun Shin, Ju-Hee Yoon, Suhra Kim, Hayan Kwon, Sungbo Shim, Dong Yeob Shin, Minseo Gim, Younglim Kho, JoonHo Lee","doi":"10.3803/EnM.2025.2475","DOIUrl":"10.3803/EnM.2025.2475","url":null,"abstract":"<p><strong>Backgruound: </strong>Endocrine-disrupting chemicals (EDCs) are environmental pollutants that may impair maternal and fetal health by disrupting hormonal systems, including the thyroid. Both iodine deficiency and excess are associated with thyroid dysfunction and adverse obstetrical outcomes. However, the combined impacts of EDCs and iodine exposure on maternal-fetal thyroid homeostasis remain undetermined. We established the Investigating Birth and Thyroid Outcomes of Maternal-Fetal Environmental Exposures (IBM-E) cohort to prospectively assess the effects of maternal exposures to dietary iodine and EDCs on thyroid function, pregnancy complications, and offspring growth and development.</p><p><strong>Methods: </strong>In this prospective observational study, we aim to enroll 556 pregnant women between 2024 and 2027 at a tertiary hospital in Korea. Maternal blood and urine samples will be collected at six time points, spanning from early pregnancy through 15 months postpartum, with infant samples collected at three time points. EDCs will be quantified using ultra-high performance liquid chromatography-tandem mass spectrometry. Thyroid function and urinary iodine concentration will be measured in both mothers and infants.</p><p><strong>Results: </strong>As of the current interim analyses of 193 mothers and 229 neonates, 15.0% of mothers had thyroid dysfunction and 11.4% developed preeclampsia. Preterm birth occurred in 23.8% of cases, and 16.6% of neonates were small for gestational age.</p><p><strong>Conclusion: </strong>The IBM-E cohort is designed to enable the longitudinal assessment of gestational environmental exposures and their potential impacts on maternal and fetal thyroid function, as well as pregnancy and neonatal outcomes. The findings of this study may inform preventive strategies and guide policy development in perinatal environmental health.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"940-949"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Liquid Chromatography-Tandem Mass Spectrometry Outperforms Radioimmunoassay in Guiding Surgical Decisions Based on Adrenal Venous Sampling in Primary Aldosteronism.","authors":"Bo-Ching Lee, Chien-Wei Huang, Chin-Chen Chang, Guan-Yuan Chen, Jia-Zheng Huang, Pin-Chen Chen, Te-I Weng, Kao-Lang Liu, Vin-Cent Wu, Yen-Hung Lin","doi":"10.3803/EnM.2024.2237","DOIUrl":"10.3803/EnM.2024.2237","url":null,"abstract":"<p><strong>Backgruound: </strong>Adrenal venous sampling (AVS) is essential for diagnosing unilateral aldosterone oversecretion in primary aldosteronism (PA). Traditionally, AVS relies on radioimmunoassay (RIA) to measure plasma aldosterone concentration (PAC), although RIA has limited specificity and considerable variability. This study evaluated the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS) in AVS and its impact on clinical outcomes.</p><p><strong>Methods: </strong>Among 230 patients with PA (May 2020 to April 2023) who underwent AVS, successful sampling was achieved in 182 patients (79.1%) under unstimulated conditions and 206 patients (89.6%) under stimulated conditions. PAC levels from peripheral and adrenal veins measured by LC-MS/MS were compared with RIA results. Patient outcomes were categorized according to the Primary Aldosteronism Surgical Outcomes criteria.</p><p><strong>Results: </strong>LC-MS/MS showed significant correlations with PAC levels measured by RIA in AVS (r=0.40 [unstimulated] and r=0.56 [stimulated]; both P<0.001). However, lateralization concordance between RIA and LC-MS/MS was moderate, at only 57.7% (unstimulated) and 64.6% (stimulated). LC-MS/MS identified more unilateral disease than RIA under both unstimulated (61.5% vs. 37.4%, P<0.001) and stimulated conditions (36.4% vs. 9.7%, P<0.001). Patients achieving complete clinical success after adrenalectomy were more accurately identified by LC-MS/MS than RIA under stimulated (55.6% vs. 22.2%, P=0.035), but not in unstimulated conditions.</p><p><strong>Conclusion: </strong>LC-MS/MS outperformed RIA in identifying unilateral disease, resulting in higher rates of complete clinical success in adrenalectomy patients when surgical decisions were based on LC-MS/MS lateralization results.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"1002-1011"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High TRAb Titer at Diagnosis Predicts Persistent Positivity and Relapse in Graves' Disease after Prolonged Antithyroid Therapy.","authors":"Zimiao Chen, Jinglu Xu, Wenrui Kang, Yang Zhang, Rujun Chen, Xiaohua Gong","doi":"10.3803/EnM.2025.2405","DOIUrl":"10.3803/EnM.2025.2405","url":null,"abstract":"<p><strong>Backgruound: </strong>The association between high thyrotropin receptor antibody (TRAb) titers at diagnosis and long-term outcomes following prolonged antithyroid drug (ATD) therapy in Graves' disease (GD) remains unclear. This study examined TRAb dynamics and outcomes in high-titer patients receiving prolonged ATD.</p><p><strong>Methods: </strong>In this retrospective cohort (2018-2021), 1,148 of 3,052 newly diagnosed GD patients met inclusion criteria (≥18-month ATD course, TRAb negativity before withdrawal, and ≥12-month follow-up). Initial TRAb levels were defined as low-titer (<5.25 IU/L, 3×upper normal limit [UNL]), intermediate-titer (5.25-10.5 IU/L), and high-titer (>10.5 IU/L, 6×UNL). Outcomes included TRAb dynamics, treatment duration, and relapse.</p><p><strong>Results: </strong>High-titer patients required longer therapy (50 months vs. 30 months vs. 22 months, P<0.001) and slower thyroid-stimulating hormone normalization (6 months vs. 4 months vs. 2 months, both P<0.001). TRAb negativity at 24/48 months occurred in 91.85%/99.26% (low-titer), 52.38%/75.24% (intermediate-titer), and 12.70%/52.68% (high-titer) (P<0.001). High-titer patients showed fluctuant (46.20%) or smoldering (28.89%) trends. Remission rates declined with higher TRAb titer (60.45% vs. 42.70% vs. 30.47%, P<0.001). High-titer patients showed increased risk of persistent TRAb positivity (2.17-fold; 95% confidence interval [CI], 1.55 to 3.05) and relapse (1.66-fold; 95% CI, 1.45 to 3.22). Thresholds of 10.90 IU/L and 16.01 IU/L predicted positivity and relapse, respectively. Definitive therapy post-relapse was more common in high-titer patients (38.29% vs. 16.98% in low-titer, P<0.001).</p><p><strong>Conclusion: </strong>High TRAb titers strongly predict persistent TRAb positivity and relapse after ATD withdrawal. Cut-off at 10.90 and 16.01 IU/L may guide prognosis and treatment.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"950-960"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Utility of Liquid Chromatography-Tandem Mass Spectrometry for Thyroglobulin Measurement in Comparison with Immunoradiometric Assay and Chemiluminescence Microparticle Immunoassay.","authors":"Hyunju Park, Eungjun Yoon, Sang-Mi Kim, Tae Hyuk Kim, Jae Hoon Chung, Soo-Youn Lee, Sun Wook Kim","doi":"10.3803/EnM.2025.2413","DOIUrl":"10.3803/EnM.2025.2413","url":null,"abstract":"<p><strong>Backgruound: </strong>The liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed to overcome interference from thyroglobulin autoantibodies (TgAb); however, it has not yet been implemented in Korea. This study aimed to confirm the accuracy of LC-MS/MS compared to conventional methods and to identify its advantages in patients with thyroid carcinoma (TC).</p><p><strong>Methods: </strong>A total of 206 TC and 18 Hashimoto's thyroiditis samples were collected. TgAb-positive (TgAb-P) was defined as TgAb >60 U/mL. Tg testing was performed using LC-MS/MS, immunoradiometric assay (Tg-IRMA), and chemiluminescence microparticle immunoassay (Tg-CMIA). The interference of TgAb in LC-MS/MS and CMIA methods was evaluated through an in vitro TgAb spiking experiment.</p><p><strong>Results: </strong>The frequency of TgAb-P in TC samples was 76.2%. Correlations between assays were as follows: Tg measurements made by LC-MS/MS (Tg-MS) and Tg-IRMA (R=0.93), Tg-MS and Tg-CMIA (R=0.96), and Tg-CMIA and Tg-IRMA (R=0.99), and it was lower in TgAb-P than TgAb-negative group. Clinical factors (total thyroidectomy, thyroid lobectomy, and Hashimoto's thyroiditis) did not affect these correlations. In TgAb spiking experiments, Tg-CMIA showed false negatives in TgAb-P, whereas Tg-MS did not. Among 21 TC cases with highly suspicious disease recurrence but Tg-IRMA <1 ng/mL, Tg-MS detected Tg ≥0.5 ng/mL in six samples. However, there was no consistent pattern of recurrence or TgAb trends.</p><p><strong>Conclusion: </strong>Correlations between assays were lower in TgAb-P cases. The spike test results show Tg-MS is less prone to false negatives in TgAb-P cases. Tg-MS may improve Tg detection in TgAb-P cases. However, we could not identify a distinct patient group with shared clinical features that would benefit from Tg-MS.</p>","PeriodicalId":520607,"journal":{"name":"Endocrinology and metabolism (Seoul, Korea)","volume":" ","pages":"928-939"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12765873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144986272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}