Hormones (Athens, Greece)最新文献

{"title":"Reproduction and fertility issues in women with congenital adrenal hyperplasia: pathophysiology, management, and recent clinical advances.","authors":"İnan Anaforoğlu, Melek Eda Ertörer","doi":"10.1007/s42000-026-00808-w","DOIUrl":"https://doi.org/10.1007/s42000-026-00808-w","url":null,"abstract":"<p><p>Congenital adrenal hyperplasia (CAH), commonly caused by 21-hydroxylase deficiency (21-OHD), is an autosomal recessive disorder of adrenal steroidogenesis with significant implications for reproductive health. This review examines the pathophysiological mechanisms, fertility outcomes, and management strategies pertaining to reproductive function in women with classical and non-classical (NC) CAH. Fertility is generally reduced in women with classical CAH compared to the general population, owing to a combination of anatomical alterations from prenatal androgen exposure and reconstructive surgery, hypothalamic-pituitary-ovarian (HPO) axis dysregulation driven by excess adrenal androgens and progesterone, anovulation, and psychosexual factors, including altered gender-related behaviour and reduced reproductive intent. In NC CAH, fertility is only mildly impaired and most women can conceive; however, miscarriage rates are substantially higher in the absence of treatment. Optimised glucocorticoid replacement therapy is the cornerstone of management, restoring ovulatory cycles and improving conception rates in both phenotypes by suppressing adrenal androgen and progesterone excess. When ovulation fails to occur, induction with clomiphene citrate or gonadotropins may be employed; in vitro fertilisation with preimplantation genetic testing represents an option for refractory cases at high genetic risk. Pregnancy in CAH requires careful obstetric monitoring, glucocorticoid dose adjustment, and stress-dose coverage during labour. Prenatal treatment with dexamethasone to prevent virilisation of possibly affected female foetuses remains a subject of ongoing ethical and clinical debate. A multidisciplinary approach-encompassing endocrinology, reproductive medicine, surgery, and psychological support-is essential for optimising reproductive outcomes and quality of life in women with CAH.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148440290","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":"Efficacy of bariatric techniques in the management of pediatric and adolescent obesity: a systematic review.","authors":"Maria Athanasopoulou, George Paltoglou, Evangelia Charmandari","doi":"10.1007/s42000-026-00809-9","DOIUrl":"https://doi.org/10.1007/s42000-026-00809-9","url":null,"abstract":"<p><p>Pediatric-adolescent obesity is a serious, multifactorial-multisystem disease associated with severe comorbidities. Surgical interventions provide a dependable approach for achieving sustained weight loss. This systematic review evaluated the effectiveness and safety of various bariatric procedures in severely obese children and adolescents. It focused on weight reduction, comorbidity resolution, postoperative complications and factors influencing the surgical decision-making process. Registered with INPLASY (INPLASY202650119), this review followed the PRISMA guidelines. PubMed, Scopus and Cochrane databases were searched until August 2024 for English-language studies, published between January 2005 and August 2024, enrolling adolescents aged 12-19 years who underwent bariatric surgery. Risk of bias was assessed using the NOS and EPHPP tools and data were synthesized qualitatively. A total of 39 articles fulfilled the eligibility criteria, including 33 observational studies, three randomized controlled trials and three clinical trials, encompassing 7,375 participants (4,770 female-1,591 male). Risk of reporting bias was deemed low. Roux-en-Y gastric bypass (RYGB) offers substantial weight loss and comorbidity resolution but carries higher micronutrient deficiency risks. Laparoscopic adjustable gastric banding (LAGB), while less invasive, is associated with higher reoperation rates and less durable weight loss. Sleeve gastrectomy (SG) is a viable alternative with fewer complications but may be less effective for diabetes remission. The decision to undergo surgery is multifactorial, shaped by medical necessity, financial and geographical accessibility and psychosocial determinants. In conclusion, bariatric surgery is an effective intervention for severe pediatric obesity, achieving significant weight reduction and metabolic improvements. Procedure selection should be individualized, weighing risks and benefits. Ongoing research and long-term follow-up are essential to optimize surgical outcomes and patient care.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439812","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":"Correction to: Advances in diabetes technology: clinical implications, limitations, and future perspectives.","authors":"Maria Apostolopoulou, Grigoris Effraimidis","doi":"10.1007/s42000-026-00803-1","DOIUrl":"10.1007/s42000-026-00803-1","url":null,"abstract":"","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439848","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":"Highly selective SGLT2 inhibitors suppress glucose uptake in alpha-TC1 cells, while glucagon secretion is not affected.","authors":"Licht Miyamoto, Suguru Nakayama, Honoka Endoh, Kano Fujiwara, Mana Hattori, Takashi Yasuoka, Masaki Imanishi, Yasumasa Ikeda, Koichiro Tsuchiya","doi":"10.1007/s42000-026-00805-z","DOIUrl":"https://doi.org/10.1007/s42000-026-00805-z","url":null,"abstract":"<p><strong>Purpose: </strong>The existence of sodium-glucose cotransporter 2 (SGLT2) in pancreatic alpha cells and its potential roles in glucagon secretion remain controversial despite its well-established function in renal glucose reabsorption. While some studies suggest SGLT2 presence and its involvement in glucagon regulation, others report no expression in alpha cells.</p><p><strong>Methods: </strong>To clarify this dispute, we investigated the acute functional effects of the highly selective SGLT2 inhibitors dapagliflozin and empagliflozin on glucose uptake, intracellular ATP levels, and glucagon secretion in alpha-TC1 cells, a widely used model of glucagon-secreting cells in culture.</p><p><strong>Results: </strong>The SGLT2 inhibitors significantly suppressed basal glucose uptake in alpha-TC1 cells, suggesting the presence of functional SGLT2. However, the inhibitors did not affect glucagon secretion. Neither the SGLT2 inhibitors nor the more potent glucose transport inhibitor, cytochalasin B, altered intracellular ATP levels or glucagon secretion. In contrast, pharmacological inhibition of K/ATP channels increased glucagon secretion without affecting glucose uptake or ATP levels.</p><p><strong>Conclusion: </strong>These results suggest that while SGLT2 is functionally present at low levels and mediates basal glucose uptake in alpha-TC1 cells, its inhibition has insufficient influence on intracellular ATP levels, and therefore, glucagon secretion remains stable. Furthermore, our observations support predominant involvement of K/ATP channels in regulating glucagon secretion.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414663","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":"Papillary thyroid carcinoma discovered in a patient on semaglutide therapy for metabolic syndrome: a case presentation and review of current evidence.","authors":"Jawad Haddadin, Aus Haddad, Lina Nahar, Osama Hamarneh, Fares Haddad","doi":"10.1007/s42000-026-00801-3","DOIUrl":"https://doi.org/10.1007/s42000-026-00801-3","url":null,"abstract":"<p><strong>Background: </strong>Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), is widely used for the management of type 2 diabetes, metabolic syndrome, and obesity. Concerns regarding its potential association with thyroid cancer, particularly medullary thyroid carcinoma, have emerged, although current human evidence remains inconclusive. Reports of papillary thyroid carcinoma (PTC) while using semaglutide therapy are exceedingly rare.</p><p><strong>Case presentation: </strong>We describe a 40-year-old man with metabolic syndrome and obesity who had been treated with semaglutide for several years before discontinuation. A routine chest computed tomography (CT) performed for an unrelated diaphragmatic hernia identified a suspicious thyroid lesion, later confirmed by ultrasound as a 1 × 1 cm irregular hypoechoic nodule in the left lobe with several small ipsilateral lymph nodes demonstrating suspicious features. Fine-needle aspiration cytology revealed classic PTC (Bethesda VI). The patient underwent total thyroidectomy with left selective neck dissection and central compartment dissection. Histopathology confirmed a unifocal classic variant PTC, 16 mm in size, with negative margins, no lymph node involvement, and no extrathyroidal extension. After an uncomplicated postoperative course, he was prescribed levothyroxine for TSH suppression and discharged.</p><p><strong>Conclusion: </strong>This case of PTC discovered concomitantly while the patient was on semaglutide therapy highlights an important clinical scenario but does not provide evidence of causation. The totality of available human data continues to support the safety of semaglutide with respect to thyroid cancer risk. Further long-term surveillance and high-quality epidemiological studies remain warranted.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335381","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":"Non-invasive imaging diagnostic techniques in metabolic dysfunction-associated steatotic liver disease: a roadmap for clinicians.","authors":"Ioannis Lamprinakos, Myrsini Orfanidou, Vasileios Rafailidis, Stergios A Polyzos","doi":"10.1007/s42000-026-00802-2","DOIUrl":"https://doi.org/10.1007/s42000-026-00802-2","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed nonalcoholic fatty liver disease (NAFLD), is the most prevalent chronic liver disorder globally and is strongly associated with obesity, type 2 diabetes mellitus, and the metabolic syndrome. Accurate and timely assessment of hepatic steatosis and fibrosis is critical for risk stratification and therapeutic monitoring. However, liver biopsy, the current reference standard, is invasive, subject to sampling variability, and unsuitable for repeated assessments of a large population. Non-invasive imaging modalities have emerged as potential alternatives, offering reproducibility and possibility for quantitative evaluation. Ultrasound-based techniques are focused on qualitative and sometimes quantitative assessment of liver fat, while elastography techniques are focused on liver stiffness, which is associated with fibrosis stage. Magnetic resonance techniques offer highly reproducible evaluation of steatosis, metabolic alterations, and fibrosis, with magnetic resonance imaging-proton density fat fraction regarded as the reference standard for fat quantification and magnetic resonance elastography providing the highest accuracy for fibrosis staging. Computed tomography also enables liver fat quantification; however, its use is limited mainly because of exposure to ionizing radiation. Recent artificial intelligence (AI) applications are oriented towards enhancing diagnostic accuracy and automate quantitative assessment while supporting longitudinal monitoring. Despite these advancements, further research is required to validate emerging techniques, standardize acquisition protocols, and ensure widespread clinical implementation. This review summarizes and synthesizes current evidence on non-invasive imaging diagnostic techniques for MASLD, highlighting their strengths, limitations, and potential integration into routine clinical practice in order to reduce dependence on invasive liver biopsy.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261196","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 trends in the prevalence of type 2 diabetes mellitus: understanding trajectories through conceptual frameworks.","authors":"Deepa Bharti, Madhur Verma, Sanjay Kalra, Sanjeev Kumar, Pravin Pisudde, Nitin Kapoor, Rakesh Kakkar","doi":"10.1007/s42000-026-00791-2","DOIUrl":"https://doi.org/10.1007/s42000-026-00791-2","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is imposing a substantial and rapidly growing global health burden. Disease estimates vary widely across geographies and time periods, reflecting not only true differences in disease occurrence but also variation in demographic structures, risk factor exposures, diagnostic practices, surveillance capacity, and biological heterogeneity within T2DM itself.</p><p><strong>Methods: </strong>A narrative, integrative synthesis of global epidemiological evidence was conducted. Data were sourced from major international platforms, supplemented with peer-reviewed literature. Evidence was synthesized across time, place, and person, with explicit attention to differences in case definitions, biomarker use, screening intensity, and modeling assumptions. Conceptual frameworks were applied to interpret observed patterns.</p><p><strong>Results: </strong>Harmonized NCD-RisC analyses show a sustained rise in age-standardized prevalence from 1980 to 2014, increasing from 4.3% to 9.0% in men and from 5.0% to 7.9% in women. According to the IDF, the global burden is projected to reach 852.5 million by 2050. Approximately 42.8% (251.7 million) of cases remain undiagnosed, with the highest proportions concentrated in low-income regions. Substantial geographic heterogeneity is shaped by population aging, rising adiposity, dietary and physical activity transitions, urbanization, commercial food environments, and health system detection capacity. Subtype distribution and biological heterogeneity further contribute to variation in disease trajectories and complication profiles across populations.</p><p><strong>Conclusions: </strong>Global T2DM prevalence reflects the interaction of biological, social, and health system processes rather than incidence alone. Prevalence trajectories must be interpreted in light of surveillance limitations, diagnostic context, and within-disease heterogeneity. Addressing future burden requires combining improved detection and chronic-care capacity with upstream, life-course-oriented prevention strategies.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240947","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":"Advances in diabetes technology: clinical implications, limitations, and future perspectives.","authors":"Maria Apostolopoulou, Grigoris Effraimidis","doi":"10.1007/s42000-026-00797-w","DOIUrl":"10.1007/s42000-026-00797-w","url":null,"abstract":"<p><p>Diabetes technology has transformed substantially over the past two decades, becoming central to modern diabetes management. Continuous glucose monitoring (CGM), automated insulin delivery (AID) systems, and smart insulin pens have reshaped both the assessment of glycemic control and diabetes treatment, particularly in people with type 1 diabetes (T1D) and selected individuals with insulin-treated type 2 diabetes (T2D). Among these technologies, CGM represents a major paradigm shift, providing continuous insight into glucose trends, variability, and time spent within clinically meaningful glycemic ranges, thereby complementing-and in many cases replacing-traditional self-monitoring of blood glucose. This narrative review summarizes evidence from randomized controlled trials and real-world studies regarding the evolution of CGM technology, insulin delivery strategies-including conventional insulin pumps, sensor-augmented pumps, and hybrid closed-loop systems-and the application of these technologies in specific clinical contexts, such as pregnancy, gestational diabetes, and perioperative and inpatient settings. While these systems offer clear metabolic and psychosocial benefits, important limitations remain, particularly those related to delayed insulin pharmacokinetics, sensor lag during rapid glucose changes, and user-dependent factors. Emerging developments, including fully closed-loop and dual-hormone systems as well as the growing role of artificial intelligence in CGM data analysis and risk prediction are also explored. Future development is expected to focus on improved personalization, tighter integration of technologies, and a transition toward more predictive and proactive diabetes care.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148230476","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":"Prognostic factors for cardiovascular complications induced by catecholamines in pheochromocytomas and paragangliomas: a systematic review and meta-analysis.","authors":"Eleftheria Kakargia, Charalampos Tsentidis, Athanasios Fountas, Emmanouil Mantzouranis, Georgia Kanti, Athina Markou, Labrini Papanastasiou","doi":"10.1007/s42000-026-00798-9","DOIUrl":"https://doi.org/10.1007/s42000-026-00798-9","url":null,"abstract":"<p><strong>Purpose: </strong>Pheochromocytomas and paragangliomas (PPGLs) can trigger major cardiovascular events (MACEs) due to unpredictable release of catecholamines. The aim of this systematic review and meta-analysis was to determine prognostic factors associated with MACEs in PPGLs patients.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed and the Cochrane Library from January 1980 to March 2026. Assessment of clinical, laboratory, imaging, histological, and genetic parameters was performed on the pooled data.</p><p><strong>Results: </strong>Nine retrospective cohort studies involving 1566 patients with PPGL were included. MACEs were observed in 302 patients [pooled estimate of 21% (95% CI 14-29%)], 95 of those having Takotsubo syndrome [pooled estimate 39% (95% CI 23-54%)]. Tumor necrosis/hemorrhage and diabetes were associated with increased risk of MACEs [71% (95% CI 25-115%, p < 0.001) and 56% (95% CI 2-109%, p = 0.02), respectively]; additional predictors of MACES were dyspnea and chest pain [5-fold (95% CI 3.3-7.4, p < 0.001) and 2.7-fold (95% CI 1.5-4, p < 0.001) increased risk of MACEs]. Patients with MACEs had an average maximum diastolic blood pressure increase of 19.3 mmHg (95% CI 2.5-36mmHg, p = 0.02) and 9.4 mm larger tumor size (95% CI 1.2-17.56, p = 0.02) than those without. No significant associations between age, adrenergic-noradrenergic phenotype, metastatic disease, familial PPGLs, and MACEs were found.</p><p><strong>Conclusion: </strong>This is, to the best of our knowledge, the first meta-analysis of cohort studies of catecholamine-induced MACEs in patients with PPGL. 21% of PPGL cases developed MACEs. Necrosis/hemorrhage, dyspnea, chest pain, and diabetes were associated with an increased likelihood of development of MACEs. However, these results should be interpreted with caution due to statistical and methodological heterogeneity.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207615","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":"Associations between multiple metabolic indices and circadian syndrome: a cross-sectional study with mediation analysis of the C-reactive protein triglyceride glucose index.","authors":"Shuang Deng, Zhongqiang Guo, Si Zhang, Ning Yao","doi":"10.1007/s42000-026-00794-z","DOIUrl":"https://doi.org/10.1007/s42000-026-00794-z","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to comprehensively investigate the independent associations between a wide array of novel metabolic indices and the prevalence of circadian syndrome (CircS), as well as to explore, within a cross‑sectional framework, whether the C‑reactive protein triglyceride glucose index (CTI) shows statistical associations consistent with mediation.</p><p><strong>Methods: </strong>A cross‑sectional analysis was conducted using data from the China Health and Retirement Longitudinal Study (CHARLS) 2015 wave, involving 6,507 participants aged ≥ 45 years. Multivariable logistic regression, restricted cubic splines, and mediation analyses were employed to assess associations, non‑linearity, and indirect effects (cross‑sectionally consistent with mediation).</p><p><strong>Results: </strong>In fully adjusted models, multiple metabolic indices - including dynapenic abdominal obesity, frailty, TyG‑related indices, and the cardiometabolic index (CMI) - showed significant positive associations with CircS prevalence (all P < 0.001), while CCR was inversely associated. Restricted cubic spline analyses revealed significant non‑linear relationships for all indices (log‑likelihood ratio test P < 0.001). Mediation analysis indicated that CTI had a statistically significant indirect effect (cross‑sectionally consistent with mediation), with the proportion of the total effect statistically attributable to CTI ranging from 20.8% to 86.5%.</p><p><strong>Conclusion: </strong>This large‑scale cross‑sectional study identified significant, often non‑linear, associations between multiple novel metabolic indices and CircS. CTI, a composite marker of inflammation and metabolism, showed a substantial indirect effect cross‑sectionally consistent with mediation in these associations. These hypothesis‑generating findings highlight the potential importance of the \"metabolic‑inflammatory\" axis in relation to CircS and offer epidemiological clues for early identification and risk stratification. Prospective studies are needed to assess temporality and causality.</p>","PeriodicalId":520640,"journal":{"name":"Hormones (Athens, Greece)","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148207617","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}