The Journal of clinical endocrinology and metabolism最新文献

{"title":"Novel Inpatient Automated Self-Adjusting Subcutaneous Insulin Algorithm: Three-Year Experience. An observational study.","authors":"Robert J Rushakoff, Esther Rov-Ikpah, Gwendolyn Lee, Paras B Mehta, Craig San Luis, Craig Johnson, Suneil Koliwad, Cynthia Fenton, Michael A Kohn","doi":"10.1210/clinem/dgaf376","DOIUrl":"https://doi.org/10.1210/clinem/dgaf376","url":null,"abstract":"<p><strong>Context: </strong>Achieving inpatient glycemic control in patients who are nil per os (NPO), on enteral tube feeds (TF), or total parental nutrition (TPN) remains extremely challenging.</p><p><strong>Objective: </strong>To determine if, for inpatients with hyperglycemia who are NPO, on TF, or on TPN, an automated self-adjusting subcutaneous rapid acting insulin algorithm (SQIA) we developed and programmed into the EMR leads to improvements in glucose control compared to conventional insulin treatment (CI).Design/Intervention/Setting/PatientsRetrospective cohort study using EMR data from 9/3/2020 to 9/2/2023, of all adult inpatients, comparing point-of-care (POC) glucose measurements between patients on SQIA versus CI and either NPO, or on TF, or on TPN. The analysis looked at the proportion of q4 hour POC glucose levels in the following ranges: hypoglycemia (<70 mg/dL), in range (71-180 mg/dL), moderate hyperglycemia (181-250 mg/dL), and severe hyperglycemia (>250 mg/dL).</p><p><strong>Results: </strong>There were 5,031 intervals (associated with 4310 hospitalizations) in which the patient was NPO or on TF or TPN and on the SQIA (73.5%) or CI (26.5%). The proportion of glucose values in the hypoglycemic and severely hyperglycemic ranges were significantly lower in the SQIA group vs. the CI group (hypoglycemia: 0.65% vs. 1.10%; difference -0.45%; -0.62 to -0.28%; p < 0.001; hyperglycemia: 5.40% vs. 6.65%; difference -1.25%; -2.03% to -0.46%; p = 0.002). With glucocorticoids, rates of severe hyperglycemia were lower for patients on the SQIA, particularly those receiving high-dose glucocorticoids (11.1% lower).</p><p><strong>Conclusions: </strong>Patients had a lower proportion of both hypoglycemic and severely hyperglycemic measurements when their blood glucose levels were managed using the SQIA than when managed using conventional physician-driven insulin orders.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487704","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: \"Effective Brief, Low-impact, High-intensity Osteogenic Loading in Postmenopausal Osteoporosis\".","authors":"","doi":"10.1210/clinem/dgaf354","DOIUrl":"https://doi.org/10.1210/clinem/dgaf354","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532927","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":"Genetics of Growth Hormone Deficiency: Insights from a Cohort of 203 Patients.","authors":"Ana Cláudia Ribeiro, Eduarda Coutinho, Najeeb Syed, Margarida Bastos, Conceição Bacelar, Carla Costa, Paula Freitas, Leonor Gomes, Ana Agapito, Fernando Fonseca, Daniela Amaral, Davide Carvalho, Maria Lurdes Sampaio, Bernardo Dias Pereira, Ana Maria Antunes, Valeriano Leite, João Jácome Castro, Luísa Barros, Rosa Pina, Sofia Almeida Martins, Mariana Martinho, Diana Martins, Henrique Vara Luiz, Alice Mirante, Lurdes Lopes, Catarina Limbert, Carla Pereira, Maria Miguel Gomes, Helena Cardoso, Isabel Dinis, Sandra Paiva, Catarina Inês Gonçalves, Luís R Saraiva, Manuel Carlos Lemos","doi":"10.1210/clinem/dgaf377","DOIUrl":"https://doi.org/10.1210/clinem/dgaf377","url":null,"abstract":"<p><strong>Context: </strong>Growth Hormone (GH) deficiency is a rare disorder characterized by severe short stature, which can result from genetic mutations affecting hypothalamic-pituitary development and function.</p><p><strong>Objective: </strong>To determine the genetic basis of GH deficiency in a Portuguese cohort.</p><p><strong>Design, setting, patients: </strong>Multicentre cohort of 203 GH-deficient patients (78 with Isolated GH Deficiency (IGHD) and 125 with Combined Pituitary Hormone Deficiency (CPHD)) were analysed.</p><p><strong>Intervention: </strong>Screening of a panel of 184 GH deficiency-related genes using Sanger sequencing and Whole Exome Sequencing (WES).</p><p><strong>Main outcome measure: </strong>Rare sequence variants (population maximum allele frequency <0.01).</p><p><strong>Results: </strong>A genetic cause was identified in 23.2% of patients (9.0% in IGHD and 32.0% in CPHD). Mutations were found in the PROP1 (14.8% of patients), GLI2 (2.0%), KMT2D (1.0%), PROK2 (1.0%), PROKR2 (1.0%), CDON (0.5%), COL1A2 (0.5%), COL2A1 (0.5%), GHRHR (0.5%), PTPN11 (0.5%), and SOX3 (0.5%) genes. One patient (0.5%) had a digenic mutation in the BMP4 and NF1 genes. Variants of Uncertain Significance (VUS) were identified in 87.8% of patients.</p><p><strong>Conclusions: </strong>This study revealed several novel and recurrent mutations that expand the genetic spectrum of GH deficiency and underscore the genetic heterogeneity of this disorder. A significant proportion of patients remained genetically undiagnosed, suggesting the involvement of additional unknown genetic, epigenetic, or environmental factors. These findings contribute to the understanding of the genetic architecture of GH deficiency and highlight the need for further investigations to elucidate underlying mechanisms and identify additional causative factors.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487702","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":"Debate about the Free Testosterone Hypothesis: Useful Tool or Misguided Mirage?","authors":"Bradley D Anawalt, David J Handelsman","doi":"10.1210/clinem/dgaf370","DOIUrl":"https://doi.org/10.1210/clinem/dgaf370","url":null,"abstract":"<p><p>In this debate, two clinicians discuss the merits and demerits of the free testosterone hypothesis. Although most clinical guidelines recommend the measurement of free testosterone in the evaluation for male hypogonadism (at least in men with suspected low serum sex hormone binding globulin), there remains controversy about underlying hypothesis that serum free testosterone is a significant contributor to androgen effect. In this debate, Dr. Anawalt presents evidence to support the free testosterone hypothesis and advocates for the usefulness of accurate assessment of free testosterone in the evaluation of male hypogonadism. Dr. Handelsman argues that the evidence is unconvincing, the hypothesis is flawed and biologically invalid, and free testosterone cannot be accurately assessed in clinical practice.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532928","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":"Multidimensional Pancreatic Islet β-cell Function (PIF) Assessment Improves Predictive Effect of Diabetes Risk Scores.","authors":"Qi Fu, Hao Dai, Jiachen Wang, Lei Liu, Lilian Fernandes Silva, Hemin Jiang, Yu Qian, Zhenzhen Fu, Ruyi Peng, Zhijie Xia, Xiaomeng Chu, Markku Laakso, Xianyong Yin, Tao Yang","doi":"10.1210/clinem/dgaf372","DOIUrl":"https://doi.org/10.1210/clinem/dgaf372","url":null,"abstract":"<p><strong>Aims/hypothesis: </strong>Comprehensive assessment of pancreatic islet β-cell function (PIF) is crucial for diabetes management. We proposed a multidimensional, relative quantification system for PIF measurement.</p><p><strong>Methods: </strong>Our novel approach evaluates PIF using three dimensions: stationary-baseline (PIF-S), load-peak (PIF-L), and accelerated-slope (PIF-A). The system was evaluated in 814 JR Cohort volunteers (195 metabolically healthy, 619 abnormal), 12 Botnia clamp study participants, 3394 type 2 diabetes patients, and 6345 METSIM cohort study participants. Restricted Cubic Spline (RCS) modeling determined ideal values based on human physiological parameters. Each subject's actual values were compared with predicted ideals and converted into percentile indices.</p><p><strong>Results: </strong>The Botnia clamp experiment confirmed distinct meaning of three PIF indices. Cluster analysis in metabolically abnormal individuals identified three clusters. Cluster 1, with the highest PIF-A, had the best metabolic profiles and lowest cardiovascular and renal disease risks. Cluster 3, with the highest PIF-S and PIF-L but lowest PIF-A, had the poorest metabolic profiles and highest disease risks. Type 2 diabetes patients with high PIF-S and PIF-L were more prone to complications. Similar patterns were observed in the METSIM cohort, Cluster 1 showing the lowest diabetes risk, with hazard ratios for Clusters 2 and 3 at 2.499 (95% CI 1.932-3.233, P = 3.11E-12) and 3.185 (95% CI 2.353-4.311, P = 6.35E-12), respectively. The novel three-dimensional PIF indices surpass previous indicators in predicting diabetes. Combined with existing diabetes risk scores, novel PIFs also significantly improved their predictive efficiency.</p><p><strong>Conclusions: </strong>This novel system offers an effective method for PIF assessment, enhancing diabetes prediction and management by deepening the understanding of diabetes complexity and aiding in precise therapy.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532897","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":"Incidence of adrenal masses eventually discovered in patients screened for primary aldosteronism.","authors":"Gregory A Kline, Joshua Low, Joshua James Burkart, Xun Yang Hu, Kaitlyn Mellor, Stefan Przybojewski, James King, Alexander A Leung","doi":"10.1210/clinem/dgaf371","DOIUrl":"https://doi.org/10.1210/clinem/dgaf371","url":null,"abstract":"<p><strong>Context: </strong>Biochemical screening for endocrine hypertension may be complex; the known presence of an adrenal mass markedly increases the pre-test probability for adrenal hypertension and may inform diagnostic efforts.</p><p><strong>Objective: </strong>Model the potential incidence of adrenal masses that may be detected by routine adrenal imaging in patients with suspected endocrine hypertension.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Provincial administrative and clinical databases for radiology and biochemistry, Alberta, Canada.</p><p><strong>Participants: </strong>Patients with hypertension and any measurement of aldosterone-renin-ratio (ARR), 2012-2019.</p><p><strong>Main measures: </strong>Radiology report of any CT or MR abdomen performed for any reason 0-12 years following ARR. Patients with any pre-ARR imaging data between 2002-2024 were excluded. Presence of adrenal mass, size and density were recorded and stratified by imaging indication.</p><p><strong>Results: </strong>Of 6942 unique hypertension patients with ARR, 1462(21%) had imaging done at some point after ARR; 912(62.4%) for indications unrelated to hypertension/adrenal and at a median 771 days (69-1577) post ARR. The incidence rate estimate was 7.2% (5.6-9.2%) of scans showed adrenal mass, median 1.4 cm (1.1-2.3), a rate well above modern series of adrenal incidentaloma prevalence in unselected adults. The number-needed-to-screen in this population was 14 (11-18) to detect an adrenal mass without a priori indication for adrenal imaging.</p><p><strong>Conclusions: </strong>Among patients screened for PA but without prior or subsequent directed adrenal imaging, 1 in 14 were later found to have an adrenal mass on imaging done for other indications. Given the impact upon pre-test probability for endocrine hypertension and further investigation steps, routine adrenal imaging might be considered whenever PA suspicion is high.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532929","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":"Propionate enhances the browning of adipose mesenteric tissue, reduces inflammation and increases thermogenic activity.","authors":"Sara de Castro Oliveira, Fabio Vasconcellos Comim","doi":"10.1210/clinem/dgaf368","DOIUrl":"https://doi.org/10.1210/clinem/dgaf368","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513086","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":"Treatment of Hypothyroidism that Contains Liothyronine is Associated with Reduced Risk of Dementia and Mortality.","authors":"Fabyan Esberard de Lima Beltrão, Giulia Carvalhal, Vandrize Meneghini, Danielle Albino Rafael Matos, Daniele Carvalhal de Almeida Beltrão, Bruna Albino Rafael Matos Andrade, Fabyo Napoleão de Lima Beltrão, Helton Estrela Ramos, Miriam O Ribeiro, George Golovko, Matthew D Ettleson, Antonio C Bianco","doi":"10.1210/clinem/dgaf367","DOIUrl":"https://doi.org/10.1210/clinem/dgaf367","url":null,"abstract":"<p><strong>Introduction: </strong>Standard levothyroxine (LT4) therapy may not fully address all risks associated with hypothyroidism-especially cognitive decline, dementia, and mortality-even when TSH levels are normalized. Observational studies link hypothyroidism to higher dementia rates; the role of LT4 plus liothyronine (T3) therapies remains uncertain.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed TriNetX data, comparing 1.26 million patients with hypothyroidism (on LT4, LT4+T3, or desiccated thyroid extract [DTE]) to 3.32 million controls. Outcomes included dementia, atrial fibrillation (AFib), and mortality over 20 years of follow-up. Propensity score matching (PSM) was used to balance covariates for age, sex, and comorbidities. Adjusted hazard ratios were obtained via Cox proportional hazard modeling. A parallel systematic review and meta-analysis of 12 studies evaluated dementia risk in hypothyroidism.</p><p><strong>Results: </strong>Patients with hypothyroidism showed a ∼1.4-fold higher risk of dementia and a >2.0-fold increase in mortality-even with normal TSH-and these risks were most pronounced when TSH levels were off-target. A parallel meta-analysis indicated a 1.4-fold heightened dementia risk. In cohorts formed by PSM comparing LT4 monotherapy versus combination therapy, RR analysis indicated 27% and 31% lower dementia and mortality risks, respectively, with combination therapy. The adjusted Cox model (HR) showed 16% and 25% reductions in these outcomes for combination therapy patients.</p><p><strong>Conclusion: </strong>Despite standard LT4 therapy, hypothyroidism remains associated with heightened risks of dementia and mortality. Adding T3 may more effectively mitigate these risks than LT4 alone, but further studies are needed to confirm the cognitive and survival benefits of T3-containing regimens.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513089","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 Ontogeny of Distinct Reproductive Phenotypes in Girls at Risk for PCOS During the Postmenarchal Transition.","authors":"Laura C Torchen, Apoorva Aekka, Kelly Brewer, Ryan Sisk, Sarayu Ratnam, Camila Vendrami, Frank H Miller, Andrea Dunaif","doi":"10.1210/clinem/dgaf363","DOIUrl":"https://doi.org/10.1210/clinem/dgaf363","url":null,"abstract":"<p><strong>Context: </strong>Daughters of women with PCOS (PCOS-d) and girls with overweight/obesity (OW-g) have hyperandrogenemia (HA) beginning in childhood. However, other features of their early reproductive phenotypes differ, suggesting that there are distinct mechanisms conferring increased risk for PCOS.</p><p><strong>Objective: </strong>We performed a cross sectional study of adolescent girls during the early postmenarchal transition.</p><p><strong>Design, setting, and participants: </strong>PCOS-d (n=15), OW-g (n=12) and lean control girls (LC, n=17), were studied within 0.2-1.2 yrs of menarche. Metabolic and reproductive phenotypes were assessed.</p><p><strong>Results: </strong>SHBG levels were lower (P<0.0001) in PCOS-d and OW-g vs. LC. Free T levels were higher (P=0.02) in OW-g vs. LC. DHEAS levels were higher (P=0.04) in PCOS-d vs. LC, and trended higher in OW-g vs. LC (P=0.07). Morning LH levels were higher in PCOS-d vs. OW-g (P=0.02). LH and FSH responses to GnRH analog were also increased in PCOS-d vs. OW-g (LH AUC P=0.006, FSH AUC P=0.01). The prevalence of HA was similarly increased in PCOS-d and OW-g vs. LC (χ2 P=0.04). The prevalence of ovulatory dysfunction (OD, menses >45 d or <21 d) was increased (χ2 P=0.05) in PCOS-d vs. OW-g and LC.</p><p><strong>Conclusions: </strong>Both PCOS-d and OW-g had persistent HA during the early postmenarchal transition. However, OD and neuroendocrine abnormalities, elevated basal and stimulated LH responses to GnRH analog, were observed only in PCOS-d. These findings support the existence of distinct developmental trajectories leading to PCOS, with early neuroendocrine dysregulation in PCOS-d and peripheral, likely adiposity-related, androgen excess in OW-g.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513087","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 Role of Cortisol Secretion in Pheochromocytomas and Paragangliomas: Clinical and Perioperative Implications.","authors":"Karolina Zawadzka, Jan Calissendorff, Ewelina Rzepka, Michał Pędziwiatr, Alicja Hubalewska-Dydejczyk, Henrik Falhammar","doi":"10.1210/clinem/dgaf361","DOIUrl":"https://doi.org/10.1210/clinem/dgaf361","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytomas and paragangliomas (PPGLs) are tumors marked by excessive catecholamine secretion. Patients with pheochromocytomas may have elevated plasma glucocorticosteroid concentrations. This study aimed to evaluate the prevalence, clinical implications, and perioperative outcomes of autonomous cortisol secretion in patients with PPGLs.</p><p><strong>Design: </strong>This was a retrospective cohort study conducted across two tertiary endocrinology centers, including patients with PPGLs who underwent adrenalectomy or extra-adrenal surgery for paragangliomas.</p><p><strong>Methods: </strong>Patients were divided based on the 1 mg dexamethasone suppression test (DST) results into suppressive and non-suppressive groups (above or below 1.8 µg/dL [50 nmol/L]). Data on clinical characteristics, biochemical markers, tumor features, perioperative outcomes, and follow-up were analyzed.</p><p><strong>Results: </strong>Among 106 patients, 24.5% exhibited non-suppressive cortisol concentrations post-DST. These patients were older (median age: 66 vs. 56 years, P<0.001), predominantly female (84.6% vs. 48.8%, P=0.001), and presented with larger tumors (5.2 vs. 4.0 cm, P<0.05). Diabetes was more common in the non-suppressive group both before adrenalectomy/surgery (50.0% vs. 26.8%, P<0.05) and after (33.3% vs. 12.7%, P<0.05). The non-suppressive group had higher urinary and plasma metanephrine concentrations, lower DHEAS concentrations, and more cardiovascular diseases. Perioperative complications, including blood loss, conversion to open surgery, and prolonged hospital stays, were more frequent in the non-suppressive group (P<0.05).</p><p><strong>Conclusions: </strong>One-quarter of patients with PPGLs exhibit autonomous cortisol secretion, associated with larger tumors, higher diabetes prevalence, and increased perioperative risks. Routine DST screening may improve preoperative management and offer insights into the impact of cortisol on PPGLs outcomes.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513088","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}