The Journal of clinical endocrinology and metabolism最新文献

{"title":"Response to Letter to the Editor from Raschi et al.: \"Endocrine adverse reactions of tyrosine kinase inhibitors in combination with immune checkpoint inhibitors\".","authors":"Wen Shao, Kaiwei Yang, Difei Lu, Ying Gao, Junqing Zhang, Yang Zhang","doi":"10.1210/clinem/dgaf344","DOIUrl":"https://doi.org/10.1210/clinem/dgaf344","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144304399","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":"Maternal thyroid function during pregnancy and early adolescent regional differences in cerebral gray matter morphology.","authors":"Tessa A Mulder, Ryan L Muetzel, Robin P Peeters, Henning Tiemeier, Tim I M Korevaar","doi":"10.1210/clinem/dgaf349","DOIUrl":"https://doi.org/10.1210/clinem/dgaf349","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormone regulates fetal brain development. Both low and high maternal thyroid function during early pregnancy has been associated with smaller offspring total gray matter and cortex volume. However, it remains unknown whether regional gray matter differences underlie global brain morphology findings.</p><p><strong>Aim: </strong>To assess the association of gestational thyroid function with regional gray matter morphology through detailed vertex-wise analysis of cortical surface area and thickness, and volumetric analyses of subcortical gray matter.</p><p><strong>Methods: </strong>We enrolled 2,426 women of the population-based prospective cohort Generation R with TSH and/or FT4 assessment before 18 weeks of gestation and offspring brain MRI scans at age 10 and/or 14 years. We studied the association of gestational TSH, FT4 and (sub)clinical thyroid disease entities with local cortical surface area, thickness and subcortical volumes.</p><p><strong>Results: </strong>There was an inverse J-shaped association of TSH with cortical surface area in the rostral middle frontal region (β[SE] for quadratic TSH: -0.005[0.001] mm2, linear TSH 0.009[0.004]). FT4 was not associated with cortical measures. Post-hoc analyses revealed an inverse J-shaped association of TSH with gyrification in a similar region and children of hyperthyroid women had less gyrification in three cortical regions, mainly frontal (-0.082[0.022], -0.077[0.020], -0.069[0.020]). Moreover, there was an inverse U-shaped association of FT4 with caudate volume (β[SE] for quadratic FT4: -0.004[0.001] SD, linear FT4 0.010[0.010]). TSH and FT4 were not associated with other subcortical volumes.</p><p><strong>Conclusion: </strong>Maternal thyroid function during early pregnancy is associated with offspring cerebral gray matter morphology in certain brain regions, specifically the frontal lobe. These findings expand on global brain morphology associations and support previous associations with behavioral outcomes.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144311209","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":"PHEX protein in the parathyroid gland contributes to phosphate sensing.","authors":"Koki Irie, Hajime Kato, Natsuho Adachi, Soichiro Kimura, Yoshitomo Hoshino, Naoko Hidaka, Sakae Tanaka, Masaomi Nangaku, Taku Saito, Noriko Makita, Nobuaki Ito","doi":"10.1210/clinem/dgaf357","DOIUrl":"https://doi.org/10.1210/clinem/dgaf357","url":null,"abstract":"<p><strong>Context: </strong>Loss-of-function variants in the PHEX gene cause X-linked hypophosphatemia (XLH) with inappropriate secretion of fibroblast growth factor (FGF) 23. The PHEX protein is therefore predicted to be involved in the phosphate (Pi)-sensing mechanism in mature osteocytes. The parathyroid glands sense short-term fluctuations in serum Pi levels and secrete parathyroid hormone (PTH) accordingly. However, the precise mechanisms for Pi sensing in the parathyroid gland have not been elucidated.</p><p><strong>Objective: </strong>To clarify the involvement of PHEX in phosphate sensing in the parathyroid glands, PTH reactions after Pi loading were retrospectively compared between patients with XLH and those with tumor-induced osteomalacia (TIO).</p><p><strong>Methods: </strong>Serum Pi, intact PTH (iPTH) and albumin-corrected serum calcium (cCa) levels at 1 hour after oral phosphate administration at doses ranging from 300 mg to 1,500 mg were analyzed. The trend of iPTH in each participant was compared between XLH and TIO.</p><p><strong>Results: </strong>Six XLH patients and 13 TIO patients were included. The serum Pi level significantly increased after the oral Pi load, whereas the serum cCa level was stable. The slope of the scatter plot of iPTH (pg/mL) versus Pi (mg/dL) after the oral Pi load for each patient was 41.4 (median) in XLH, which was significantly greater than the 7.1 in TIO (p = 0.034).</p><p><strong>Conclusion: </strong>iPTH increased in accordance with Pi levels, with a greater slope observed in XLH than in TIO after oral Pi loading. This finding suggests that PHEX in the parathyroid glands might also determine the serum Pi-sensing threshold and mediate PTH secretion in the case of abrupt fluctuations in serum Pi levels, which may explain the high prevalence of secondary and tertiary hyperparathyroidism in patients with XLH.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289754","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":"Subtle cognitive impairments and psychological complaints in patients with prolactinoma despite biochemical control.","authors":"Victoria R van Trigt, Cornelie D Andela, Leontine E H Bakker, Steffanie C M Brama, Lotte E Schmidt, Florian M Sneekes, Margot W Zeelenberg, Sasja D Huisman, Stephanie E E C Bauduin, Olaf M Dekkers, Marco J T Verstegen, Wouter R van Furth, Iris C M Pelsma, Nienke R Biermasz","doi":"10.1210/clinem/dgaf355","DOIUrl":"https://doi.org/10.1210/clinem/dgaf355","url":null,"abstract":"<p><strong>Purpose: </strong>To assess cognitive functioning and psychological complaints in patients with biochemically controlled prolactinoma.</p><p><strong>Methods: </strong>Cross-sectional study comparing otherwise healthy patients treated for prolactinoma to age-, gender-, and education-level-matched controls. The cognitive assessment included eight tests assessing memory, verbal fluency, processing speed, selective attention, and executive functioning. Additionally, patients completed seven validated questionnaires on psychological complaints. Generalized estimating equations were performed. P-values <0.050 were considered significant.</p><p><strong>Results: </strong>Sixty patients (controlled on dopamine agonists, n=30; in surgical remission, n=30), among whom 41 (68.3%) female, aged 42.3±11.7 years old, were compared to 60 matched controls. Patients scored significantly lower on assessments for verbal memory (fewer words on Verbal Learning Test of Rey: β=-1.8, 95%CI -2.7, -1.0), selective attention (fewer correct digits on Digit Deletion Test (β=-8.8, 95%CI -16.2, -0.2), longer time on Trial Making Test A (β=5.2, 95%CI 3.2, 7.2)), and processing speed (fewer correct substitutions on Digit-Symbol Substitution Test: β-4.2, 95%CI -8.2, -0.2). Furthermore, patients reported higher degrees of apathy (Apathy Scale: β=2.4, 95%CI 0.6, 4.1), irritability (Irritability Scale: β=2.2, 95%CI 0.3, 4.1), fatigue (Fatigue Severity Scale: β=6.7, 95%CI 2.7, 10.8), and anxiety and depressive symptoms (Hospital Anxiety and Depression Scale, anxiety: β=1.1, 95%CI 0.1, 2.1; depression: β=1.7, 95%CI 0.8, 2.7). Tests assessing executive functioning and task switching were comparable in patients and matched controls.</p><p><strong>Conclusions: </strong>Compared to matched controls, patients treated for prolactinoma showed subtle cognitive impairments (i.e., memory, attention, and processing speed) and reported more psychological complaints. Physicians should be aware of these impairments, and address them adequately.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289755","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":"Defining puberty and spectrum of hypogonadism in Alström Syndrome.","authors":"Sadaf Ali, Qianwen Zhang, Ijeoma Anwunah, Shanat Baig, Gabriela da Silva Xavier, Charlotte Dawson, Francesca Dassie, Yijun Tang, Libo Wang, Guoying Chang, Paul Gleeson, Adrian T Warfield, Richard Paisey, Timothy G Barrett, Pietro Maffei, Xiumin Wang, Victoria Homer, Melanie Kershaw, Tarekegn Geberhiwot","doi":"10.1210/clinem/dgaf356","DOIUrl":"https://doi.org/10.1210/clinem/dgaf356","url":null,"abstract":"<p><strong>Background: </strong>Alström syndrome (AS), has been extensively studied for its multi-system organ manifestations. Primary gonadal failure is well described in humans, but little is known about the intricacies of puberty and true incidence of hypogonadism within this population.</p><p><strong>Hypothesis: </strong>We aimed to define the onset and progression of puberty and the incidence of hypogonadism in male patients with AS.</p><p><strong>Methodology: </strong>A retrospective, observational cohort study was conducted on patients with AS across the UK and Italy national services. Additionally, the findings were correlated with Alms1 S701X mouse model as part of the current study.</p><p><strong>Results: </strong>We enrolled 28 paediatric patients (age 14.8 ±2.3) and 41 adult patients (age 34 ±12). All paediatric patients entered puberty at an appropriate age, but the highest testicular volume achieved by patients with AS was 9 ± 3ml in age group of 14-15-year-old boys. Among adults, 95% (39/41) had hypogonadism with primary gonadal failure. Testicular analysis of Alms1 S701X mouse model shows testicular atrophy with no evidence of fibrosis. Moreover, Alms1 S701X mice exhibit reduced sperm count and sperm motility compared to controls (29.03*106/ml vs 110.6*106/ml, 34.77% vs 70.18%).</p><p><strong>Conclusion: </strong>Our study sheds light on the reproductive aspects of AS across paediatric and adult populations with particular emphasis on testicular and pubertal development, and hypogonadism in adult life. Although, all the paediatric AS patients have age-appropriate onset of puberty, almost all exhibit hypogonadism with primary gonadal failure as adults. This mirrors the Alms1 S701X mouse model.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289752","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":"Precision approaches towards diabetes prevention: towards a clustering approach with more phenotypical granularity.","authors":"Ellen E Blaak","doi":"10.1210/clinem/dgaf341","DOIUrl":"https://doi.org/10.1210/clinem/dgaf341","url":null,"abstract":"","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144288156","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":"Gestational Glucose Intolerance and Risk of Obesity in Childhood and Adolescence.","authors":"Jacqueline Maya, Carolin C M Schulte, Sarah Hsu, Kaitlyn James, Tanayott Thaweethai, Deepti Pant, Marie-France Hivert, Camille E Powe","doi":"10.1210/clinem/dgaf345","DOIUrl":"10.1210/clinem/dgaf345","url":null,"abstract":"<p><strong>Objective: </strong>An association between in utero exposure to gestational glucose intolerance ([GGI], abnormal glucose screening without gestational diabetes), and offspring obesity has not been consistently observed.</p><p><strong>Methods: </strong>In a retrospective cohort, we studied the risk of obesity (body mass index [BMI] > 95th percentile), in 2-5, 6-10, and 11-18-year-olds exposed to varying degrees of maternal glycemia in utero: normal glucose tolerance (NGT), GGI (0 abnormal glucose values, GGI-0, or 1 abnormal value, GGI-1) or gestational diabetes (GDM >2 of 4 abnormal values). We used generalized estimating equations for logistic regression to estimate odds ratios for obesity in each glycemic category compared to NGT, adjusting for maternal age, parity, insurance, race/ethnicity, marital status, infant sex, gestational age, and gestational weight gain. A second model additionally adjusted for maternal 1st trimester BMI.</p><p><strong>Results: </strong>We included 27,876 children and adolescents from 23,334 (83.7%) NGT pregnancies, 3,413 (12.2%) GGI pregnancies, and 1,129 (4.1%) GDM pregnancies. The prevalence of obesity was 13.5% at age 2-5, 20.3% at age 6-10, and 23.4% at age 11-18. Those exposed to GGI-1 and GDM had increased odds of obesity compared to NGT. Adjusting for maternal BMI attenuated this association in all age and glycemic exposure groups, but it remained significantly elevated in 6-10-year-olds exposed to GDM (odds ratio (OR): 1.21, 95%CI [1.01, 1.46] and 11-18-year-olds exposed to GGI-1 and GDM (GGI-1 OR: 1.44 [1.14, 1.81]; GDM OR: 1.28 [1.03, 1.59]).</p><p><strong>Conclusion: </strong>Older children and adolescents exposed to GGI-1 and GDM in utero have a higher risk of obesity than those born to NGT pregnancies, even after accounting for maternal BMI.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289753","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":"Metabolic dysfunction-associated steatotic liver disease alters fatty acid profiles in the liver and adipose tissue.","authors":"Saana Palomurto, Kirsi A Virtanen, Vesa Kärjä, Ursula Schwab, Dorota Kaminska, Pirjo Käkelä, Jussi Pihlajamäki, Ville Männistö","doi":"10.1210/clinem/dgaf346","DOIUrl":"https://doi.org/10.1210/clinem/dgaf346","url":null,"abstract":"<p><strong>Context: </strong>The alterations in systemic fatty acid (FA) metabolism in metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear.</p><p><strong>Objective: </strong>To investigate inter-tissue crosstalk in FA metabolism in patients with MASLD, we compared FA profiles in the liver, serum, visceral, and subcutaneous adipose tissue of patients with severe obesity and normal liver, simple steatosis, or metabolic dysfunction-associated steatohepatitis (MASH).</p><p><strong>Methods: </strong>Preoperative serum, liver, subcutaneous, and visceral adipose tissue samples were collected during laparoscopic gastric bypass surgery from 183 patients with severe obesity patients (122 women, mean age 46.9 ± 9.7 years, body mass index 43.5 ± 5.7 kg/m2). FA composition was analyzed using gas-liquid chromatography. The Kruskal-Wallis test was used to compare the FA proportions in different tissue depots.</p><p><strong>Results: </strong>FA proportions varied more in the liver than in adipose tissue in patients with MASH. Polyunsaturated FAs (PUFA) proportions were significantly lower in the livers of patients with MASH than in those with normal livers (all adjusted P< 0.01). Conversely, dihomo-gamma-linolenic acid, adrenic acid, and arachidonic acid proportions were higher in the adipose tissues of patients with MASH (all adjusted p < 0.001).</p><p><strong>Conclusions: </strong>Patients with MASH exhibited reduced hepatic PUFA content, increased hepatic saturated FAs, and a higher n6-to-n3 PUFA ratio, whereas no clear trends were observed in adipose tissue. These findings highlight distinct differences in FA metabolism between the liver and adipose tissue in MASLD, emphasizing tissue-specific regulatory mechanisms.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278143","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":"Clinical and Genetic Characteristics of Adult Nonautoimmune Hypothyroidism: A Single-Institution Study.","authors":"Chiho Sugisawa, Erika Uehara, Kanako Tanase-Nakao, Kosuke Inoue, Tatsuya Iida, Fumiko Otsuka, Nami Suzuki, Hidemi Ohye, Miho Fukushita, Masako Matsumoto, Ai Yoshihara, Natsuko Watanabe, Kiminori Sugino, Jaeduk Yoshimura Noh, Matsuo Taniyama, Satoshi Narumi, Koichi Ito","doi":"10.1210/clinem/dgaf352","DOIUrl":"https://doi.org/10.1210/clinem/dgaf352","url":null,"abstract":"<p><strong>Purpose: </strong>Nonautoimmune hypothyroidism is characterized by hypothyroidism with negative thyroid autoantibodies with limited knowledge of its clinical and genetic characteristics. The aim was to characterize the clinical and genetic features of nonautoimmune hypothyroidism.</p><p><strong>Methods: </strong>This retrospective study included 1,470 treatment-naive adult hypothyroid patients (serum TSH >10 mU/L) born before 1979 and were followed up at Ito Hospital, Tokyo, Japan. Of them, 220 patients were diagnosed with idiopathic nonautoimmune hypothyroidism by thyroid autoantibody measurements. Sequencing of 13 genes associated with nonautoimmune hypothyroidism was performed of 101 of the 220 patients. Clinical characteristics, including thyroid function and morphology, were systematically evaluated.</p><p><strong>Results: </strong>The proportion of idiopathic nonautoimmune hypothyroidism among the 1,470 patients with treatment-naive non-transient hypothyroidism was 15.0%. Idiopathic nonautoimmune hypothyroidism patients had lower serum TSH (17.0 vs. 28.3 mU/L; P<0.001), higher serum fT4 (11.5 vs. 8.9 pmol/L; P<0.001), and a smaller thyroid volume (13.4 vs. 24.9 g; P<0.001) than autoimmune hypothyroidism patients. Genetic analysis showed that 5.0% of the analyzed idiopathic nonautoimmune hypothyroidism patients had a Mendelian disorder, with PAX8 being the most commonly affected gene. An additional 19% of the analyzed patients carried monoallelic variants in hypothyroidism-associated genes, such as DUOX2, DUOXA2, SLC26A4, TG, TPO, and TSHR, that cause autosomal recessive genetic defects.</p><p><strong>Conclusions: </strong>In patients with treatment-naive adult nonautoimmune hypothyroidism, thyroid dysfunction was milder, and thyroid volume was smaller than in patients with autoimmune hypothyroidism. Mendelian forms were rare, but the unexpectedly high frequency of monoallelic variant carriers suggests that these variants may confer genetic risk for nonautoimmune hypothyroidism.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278141","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":"Multiple or Single Endocrine Abnormalities Associated with Immune Checkpoint Inhibitors.","authors":"Fumika Kamitani, Yuichi Nishioka, Hiroki Nakajima, Yukako Kurematsu, Sadanori Okada, Tomoya Myojin, Tatsuya Noda, Tomoaki Imamura, Yutaka Takahashi","doi":"10.1210/clinem/dgaf347","DOIUrl":"https://doi.org/10.1210/clinem/dgaf347","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) are associated with various endocrine abnormalities. However, their underlying pathophysiology remains unclear. We investigated the effect of multiple endocrine abnormalities on the overall survival (OS) of patients treated with ICIs.</p><p><strong>Methods: </strong>In total, 12,978 patients who received ICIs between 2014 and 2022 were investigated using the DeSC Japanese administrative claims database. Endocrine abnormalities were defined by each hormone replacement therapy, including levothyroxine, hydrocortisone, and insulin, in which it is difficult to distinguish central or primary hormone defect. Also, only patients with hypothyroidism after thyroiditis were included. Type 1 diabetes was additionally defined by the name of the disease and strict self-injection fees. Regression analyses were performed to identify risk factors for endocrine abnormalities and the effect of endocrine abnormalities on OS, adjusting for confounders including the number and duration of ICI administrations.</p><p><strong>Results: </strong>Single and multiple endocrine abnormalities were observed in 12.0% and 1.4% of patients, respectively. The most common combination was hypothyroidism and adrenal insufficiency (1.3%). Kaplan-Meier analysis indicated better survival in patients with multiple and single endocrine abnormalities than in those without (P < .01). Multivariable analysis revealed lower mortality in patients with multiple and single endocrine abnormalities (adjusted hazard ratio [aHR] 0.39; 95% confidence interval [CI], 0.28-0.54, P < .01; aHR 0.65; 95% CI, 0.5-80.72, P < .01, respectively) than in those without. Mortality was significantly lower with multiple abnormalities than with single (aHR 0.56; 95% CI, 0.39-0.79, P < .01).</p><p><strong>Conclusions: </strong>The development of multiple endocrine abnormalities in patients treated with ICIs is associated with improved survival compared with that of patients with a single abnormality.</p>","PeriodicalId":520805,"journal":{"name":"The Journal of clinical endocrinology and metabolism","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278144","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}