The Journal of clinical endocrinology and metabolism最新文献

{"title":"Establishing the adequate levothyroxine dose after total thyroidectomy: A systematic review with meta-analysis.","authors":"Isabella Chiardi, Laura Croce, Paolo Caccavale, Jacopo Bertini, Francesca Coperchini, Flavia Magri, Carlo Cappelli, Pierpaolo Trimboli, Mario Rotondi","doi":"10.1210/clinem/dgaf417","DOIUrl":"https://doi.org/10.1210/clinem/dgaf417","url":null,"abstract":"<p><strong>Background: </strong>Total thyroidectomy requires lifelong levothyroxine (LT4) therapy. Achieving optimal thyroid hormone replacement at the first post-operative follow-up might be harder than it could be expected. Despite various LT4 dose choosing strategies were tested, there is no consensus on the most effective approach to achieve early euthyroidism.</p><p><strong>Materials and methods: </strong>We performed a systematic review and meta-analysis, including studies published between 2000 and 2024 that reported the proportion of patients achieving euthyroidism at first follow-up after total thyroidectomy. Data from 11 studies comprising 2577 patients were analyzed. LT4 dosing strategies included fixed-dose, weight-based (dose/kg), and individualized algorithm-based methods. Meta-regression and subgroup analyses were used to explore sources of heterogeneity.</p><p><strong>Results: </strong>The pooled euthyroidism rate at first follow-up was 33.9%, with high heterogeneity across studies (I² = 82.68%). No dosing strategy consistently outperformed others: dose/kg methods achieved 29% euthyroidism, while fixed or algorithm-based approaches achieved 40%, though without statistical significance. Meta-regression analysis did not identify any statistically significant predictor. No significant differences emerged between patients treated for benign or malignant thyroid diseases or between retrospective and prospective study designs.</p><p><strong>Conclusions: </strong>Only about one-third of patients achieve euthyroidism at first follow-up after thyroidectomy, regardless of LT4 dosing strategy. The current guidelines recommendation of applying a pro/kg dose may not be adequate, and even personalized algorithms yield inconsistent results. Future prospective studies are needed to refine individualized dosing protocols and identify additional factors influencing LT4 requirements.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669302","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":"Determinants of Pancreatic Size and Fat Content in the UK Biobank: Influence of Race, Genetic Variants, and Risk Factors.","authors":"Tanvi Kongara, Alexander Carruth, Prahlad Bhat, John Virostko","doi":"10.1210/clinem/dgaf420","DOIUrl":"https://doi.org/10.1210/clinem/dgaf420","url":null,"abstract":"<p><strong>Objective: </strong>Pancreas size and fat content differ in individuals with diabetes, but it is not clear how pancreas imaging features are impacted by race, genetics, and lifestyle factors.</p><p><strong>Methods: </strong>We performed cross-sectional analysis of 37,163 UK Biobank participants with pancreas imaging data to investigate racial and genetic influences on pancreas volume index (PVI) and pancreatic fat fraction (PFF). We further assessed the influence of prior glycemic status and lifestyle factors on pancreas size and composition after adjusting for sex and age.</p><p><strong>Results: </strong>White non-diabetic individuals had lower PVI compared to Asian participants (p < 0.0001), but higher than Black participants (p < 0.01), while PFF was highest in White participants. Similar trends were observed in participants with diagnosed diabetes. When stratified by glycemic status acquired 4-14 years prior to imaging, White and Asian participants exhibited significantly lower PVI and higher PFF with increased HbA1c. Higher polygenic risk scores (PRS) for type 2 diabetes (T2D) and HbA1c were associated with reduced PVI (ρ = -0.07, p < 0.0001 and ρ = -0.14, p < 0.0001, respectively) and elevated PFF (ρ = 0.07, p < 0.0001 and ρ = 0.18, p < 0.0001, respectively). In contrast, type 1 diabetes (T1D) PRS showed no significant association with any pancreas measures. Sedentary lifestyle behaviors associated with T2D risk at study baseline correlated with smaller PVI and increased pancreas fat 4-14 years later.</p><p><strong>Conclusions: </strong>These findings highlight contributions of race, genetics, and behaviors to pancreatic morphology and fat deposition in glycemic dysregulation.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669301","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":"Case Series of 46 Patients with Nonketotic Hyperglycemia-Associated Chorea: A Retrospective Follow-Up Study.","authors":"Xiaoyan Wu, Ruying Fu, Chao Yuan, Ruting Fu, Shijian Luo, Zhihuai Mo, Li Shi, Jianjun Guo, Qingyu Shen","doi":"10.1210/clinem/dgaf394","DOIUrl":"https://doi.org/10.1210/clinem/dgaf394","url":null,"abstract":"<p><strong>Background: </strong>Nonketotic hyperglycemia-associated chorea (NKHC) is a rare but underrecognized complication of diabetes mellitus, with unclear pathogenesis and variable clinical presentations. Recent studies highlight the role of metabolic disturbances and cerebrovascular pathophysiology in its development.</p><p><strong>Research design and methods: </strong>To investigate the clinical, imaging, and therapeutic characteristics of 46 patients with NKHC, integrating multimodal neuroimaging and long-term follow-up data from 2013 to 2022. This multicenter retrospective study enrolled patients with acute-onset hemichorea/hemiballismus, nonketotic hyperglycemia (random blood glucose ≥11.1 mmol/L), and basal ganglia abnormalities on MRI. Clinical outcomes, metabolic profiles, and neuroimaging features (including T1-weighted hyperintensity, DCE-MRI, and MRS) were systematically analyzed.</p><p><strong>Results: </strong>The cohort exhibited a mean age of 68.6 ±10.4 years (range 48-89), with equal gender distribution. Hyperglycemia (mean HbA1c 11.4%±3.8%) and T1-weighted hyperintensity in the contralateral basal ganglia were universal (91.3% on MRI). Notably, 26.1% of patients presented with normoglycemia at admission yet exhibited typical chorea, challenging the \"hyperglycemia-first\" paradigm. Follow-up MRI revealed dynamic changes in T1 signal intensity, with 2 cases demonstrating symptom exacerbation despite signal resolution. NKHC manifests heterogeneous clinical and imaging phenotypes, suggesting a multifactorial pathogenesis involving metabolic derangement, cerebrovascular insufficiency, and blood-brain barrier disruption. Normoglycemic presentations and paradoxical imaging changes warrant further mechanistic exploration.</p><p><strong>Conclusions: </strong>To our knowledge, this study represents the largest case series of nonketotic hyperglycemic chorea to date, offering valuable insights into the clinical and imaging characteristics of this condition.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669300","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":"Soothing a Ruffled Mind: Chronotherapy of Cushing Syndrome.","authors":"Henrik Elenius, Lynnette K Nieman","doi":"10.1210/clinem/dgaf353","DOIUrl":"https://doi.org/10.1210/clinem/dgaf353","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664149","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":"Letter to the Editor from Maino et al.: \"Prevalence and Management of Complications of Laser Ablation for Benign Thyroid Nodules: A Systematic Review of Literature and Meta-Analysis\".","authors":"Fabio Maino, Elisa Mattii, Maria Grazia Castagna","doi":"10.1210/clinem/dgaf411","DOIUrl":"https://doi.org/10.1210/clinem/dgaf411","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661777","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":"Myofibrillar protein synthesis rates do not differ with low and high estradiol concentrations across the menstrual cycle.","authors":"Marianna C A Apicella, Tom S O Jameson, Alistair J Monteyne, George F Pavis, Doaa R Abdelrahman, Andrew J Murton, Nima Alamdari, Marlou L Dirks, Benjamin T Wall, Francis B Stephens","doi":"10.1210/clinem/dgaf410","DOIUrl":"https://doi.org/10.1210/clinem/dgaf410","url":null,"abstract":"<p><strong>Context: </strong>Skeletal muscle can respond and adapt to sex hormones; however, the degree to which fluctuations in endogenous estradiol across the menstrual cycle (MC) influences rates of myofibrillar protein synthesis (MyoPS) is not clear.</p><p><strong>Objective: </strong>We compared MyoPS in postabsorptive and postprandial postexercise states, during the early follicular (EF; low estradiol) and late follicular (LF; high estradiol) phases of the MC.</p><p><strong>Design, setting, participants and intervention: </strong>Seventeen healthy females (age: 28±7 y; BMI: 24±3 kg.m2), participated in a randomized, cross-over trial, during the EF (day 4±1; estradiol, 183±78 pmol.L-1) and LF (day 15±3; estradiol, 855±571 pmol.L-1) phases. Following a resistance exercise bout, participants ingested an amino acid (AA) drink. Blood and muscle samples were collected, pre and postexercise and AA ingestion.</p><p><strong>Main outcome measure: </strong>Following primed-continuous infusion of L-[ring-2H5]-phenylalanine, MyoPS was measured prior to and during a 4 h postprandial postexercise period.</p><p><strong>Results: </strong>MyoPS increased above postabsorptive rates between 0-2 h to 0.111±0.049 and 0.117±0.058 %⋅h-1, (P<0.001) but not between 2-4 h (P=0.522), for EF and LF, respectively, with no interactions observed (P=0.971). Moderate correlations were shown between total and free testosterone and 0-4 h MyoPS (r=0.364, P=0.048; r=0.369, P=0.045, respectively). Expression of several genes associated with protein synthesis, muscle remodeling and inflammation were increased in LF vs EF (P<0.050), whereas protein breakdown genes were decreased.</p><p><strong>Conclusions: </strong>Despite a gene expression profile consistent with muscle growth, MyoPS did not differ with elevated estradiol concentrations. Hence, estradiol does not seem to be important for acutely regulating muscle mass in eumenorrheic females.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661778","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":"Response to Letter to the Editor from Maino et al.: \"Prevalence and Management of Complications of Laser Ablation for Benign Thyroid Nodules: A Systematic Review of Literature and Meta-Analysis\".","authors":"Lorenzo Scappaticcio, Nicole Di Martino, Pamela Ferrazzano, Maria Ida Maiorino, Paola Caruso, Alessandra Volatile, Miriam Longo, Giovanni Docimo, Eduardo Iervolino, Pierpaolo Trimboli, Katherine Esposito, Giuseppe Bellastella","doi":"10.1210/clinem/dgaf412","DOIUrl":"https://doi.org/10.1210/clinem/dgaf412","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661780","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 significance of high expression of circulating miR-222-3p in patients with unilateral primary aldosteronism.","authors":"Kentaro Okamoto, Masakatsu Sone, Daisuke Taura, Youichi Ohno, Ichiro Yamauchi, Yohei Ueda, Takuro Hakata, Mika Tsuiki, Masanori Murakami, Daisuke Yabe, Nobuya Inagaki, Mitsuhide Naruse","doi":"10.1210/clinem/dgaf408","DOIUrl":"https://doi.org/10.1210/clinem/dgaf408","url":null,"abstract":"<p><strong>Context: </strong>The significance of circulating miRNAs in primary aldosteronism (PA) is still largely unknown.</p><p><strong>Objective: </strong>We compared the profiles of circulating miRNAs between unilateral primary aldosteronism (UPA) and bilateral hyperaldosteronism (BHA) and investigated the potential role of a newly identified UPA-related miRNA in the pathogenesis of PA.</p><p><strong>Methods: </strong>We initially conducted a comprehensive expression analysis of circulating miRNAs using a qPCR panel in a small number of cases matched for background factors, followed by validation analysis with a larger sample size for the candidate miRNAs.</p><p><strong>Results: </strong>The expression level of one single miRNA, miR-222-3p, was significantly higher in UPA than in BHA, both in the adrenal veins and the inferior vena cava. Moreover, it was significantly higher in the adrenal vein on the tumor side compared to the non-tumor side within the same UPA patients. In primary cultured adrenal cells, miR-222-3p mimics appeared to increase CYP11B2 expression, although the effect was not statistically significant. However, transfection with miR-222-3p mimics significantly increased cell proliferation, while transfection with miR-222-3p inhibitors decreased it. CDKN1B was identified as a predicted target gene of miR-222-3p. Additionally, the expression level of miR-222-3p exhibited a significant positive correlation with tumor diameter and plasma aldosterone concentration after saline infusion test.</p><p><strong>Conclusions: </strong>The present results demonstrated higher expression of circulating miR-222-3p in UPA than in BHA, providing a biochemical marker for subtype diagnosis of PA. Moreover, the correlation of miR-222-3p with adrenal cell proliferation and aldosterone secretion indicated its significant involvement in the pathogenesis of PA.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661781","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":"Response to Letter to Editor from Yeap et al: \"Endogenous sex steroid hormones, sex hormone-binding globulin, and risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of prospective cohort studies\".","authors":"Hamidreza Raeisi-Dehkordi, Mojgan Amiri, Sara Beigrezaei, Hugo G Quezada-Pinedo, Marinka Steur, Angeline Chatelan, Trudy Voortman, Oscar H Franco, Taulant Muka","doi":"10.1210/clinem/dgaf415","DOIUrl":"https://doi.org/10.1210/clinem/dgaf415","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661779","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":"Letter to Editor from Yeap et al: \"Endogenous sex steroid hormones, sex hormone-binding globulin, and risk of all-cause and cause-specific mortality: A systematic review and dose-response meta-analysis of prospective cohort studies\".","authors":"Bu B Yeap, Ross J Marriott, Leen Antonio, Leon Flicker, Gary A Wittert, Frederick C W Wu, Kevin Murray","doi":"10.1210/clinem/dgaf414","DOIUrl":"https://doi.org/10.1210/clinem/dgaf414","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661776","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}