Cardiovascular diabetology. Endocrinology reports最新文献

{"title":"Cluster analysis reveals distinct inflammatory phenotypes in cardiometabolic disease.","authors":"Jaqueline Bianchi, Fernanda Oliveira Duarte, Luciana Camillo, Krissia Franco de Godoy, Joice Margareth de Almeida Rodolpho, Bruna Dias de Lima Fragelli, Maria Clara Cavalcante Espósito, Leticia Americano Branco, Carlos Speglich, Meliza Goi Roscani, Henrique Pott, Fernanda de Freitas Anibal","doi":"10.1186/s40842-025-00227-7","DOIUrl":"10.1186/s40842-025-00227-7","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease and type 2 diabetes mellitus share inflammatory pathways; however, their combined effect on systemic inflammation remains unclear. Although chronic low-grade inflammation is recognized in both conditions, the heterogeneity of inflammatory responses in patients with comorbidities has not been systematically characterized. This study aimed to identify distinct inflammatory phenotypes in patients with CVD, T2DM, or both and evaluate their clinical and biomarker profiles.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 240 outpatients from Brazilian cardiology clinics, who were categorized into three groups: CVD + T2DM+ (n = 51), CVD + T2DM- (n = 95), and controls without either condition (n = 94). Serum levels of IL-6, IL-1β, TNF-α, and cardiac biomarkers (CK-MB, NT-proBNP, D-dimer) were measured using chemiluminescence immunoassays. Gaussian Mixture Models identified inflammatory clusters, which were validated using silhouette analysis. Statistical comparisons were performed using Kruskal-Wallis tests for continuous variables and chi-square tests for categorical variables, with ridge regression to assess phenotype predictors.</p><p><strong>Results: </strong>Analysis revealed three distinct inflammatory phenotypes: Phenotype 1 (n = 74) showed the lowest inflammatory markers (IL-6:2.00 pg/mL; CRP: 3.22 mg/L) and CVD prevalence (32.4%). Phenotype 2 (n = 83) had the highest CVD burden (81.9%) but unexpectedly low TNF-α (6.37 pg/mL) despite elevated D-dimer (0.76 µg/mL). Phenotype 3 (n = 83) exhibited the most severe inflammation (TNF-α: 12.90 pg/mL; hs-CRP: 5.00 mg/L) and the highest comorbidity rate (25.3% CVD + T2DM+). Phenotype 3 also showed significantly higher CK-MB (2.46 vs. 1.00 ng/mL, p < 0.001) and IL-8 (12.6 vs. 10.85 pg/mL, p < 0.001) levels than the other groups. Regression analysis identified age (OR = 2.24, 95% CI: 1.69-3.00) and CVD (OR = 1.47, 95% CI: 1.04-2.04) as significant phenotype predictors.</p><p><strong>Conclusion: </strong>This study identified three clinically distinct inflammatory phenotypes in cardiometabolic diseases, with T2DM exacerbating systemic inflammation in patients with pre-existing CVD. The discordant phenotype (high CVD burden but low TNF-α levels) challenges current inflammatory models and suggests alternative pathways in some patients. These findings support the need for phenotype-specific approaches for risk stratification and targeted anti-inflammatory therapies in high-risk subgroups.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"15"},"PeriodicalIF":0.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of diabetes on the glymphatic system: recent advances and mechanistic insights.","authors":"AmirEhsan Lashkari","doi":"10.1186/s40842-024-00211-7","DOIUrl":"10.1186/s40842-024-00211-7","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia and is associated with a variety of systemic complications, including cardiovascular diseases, neuropathies, and cognitive decline. An emerging area of interest is the impact of diabetes on the glymphatic system, a waste clearance system in the central nervous system (CNS) that plays a critical role in maintaining brain homeostasis. Recent studies suggest that glymphatic dysfunction may contribute to the pathogenesis of diabetic encephalopathy, a condition characterized by cognitive deficits and an increased risk of neurodegenerative diseases such as Alzheimer's disease (AD). This review provides a review of the effects of diabetes on the glymphatic system, drawing on a broad spectrum of recent research. We examine the mechanistic underpinnings of glymphatic impairment in diabetes, the role of hyperglycemia and insulin resistance, and the potential therapeutic implications. We also explore the broader context of diabetes-related CNS changes, including the impact on cerebrovascular function, neuroinflammation, and sleep disturbances. Finally, we discuss future directions in this rapidly evolving field, highlighting the need for further research into the glymphatic system as a therapeutic target in diabetes.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to long-term pharmacological management of metreleptin in a patient with monogenic obesity due to mutation in the LEP gene.","authors":"Miguel Augusto O'Meara Novoa, Maria Camila Reyes Cajicá, Daniel Larrarte-Arenas, Jennifer Alexandra Palencia Ávila","doi":"10.1186/s40842-024-00207-3","DOIUrl":"10.1186/s40842-024-00207-3","url":null,"abstract":"<p><strong>Background: </strong>The cases of obesity worldwide have increased significantly, with this condition being considered a global pandemic. This pathology poses a major health problem due to its high morbidity burden. Its cause in the majority of cases is multifactorial; however, there are various cases of monogenic obesity reported in the literature. Mutation in the leptin gene causes a marked decrease in leptin levels, leading to intense hyperphagia and associated morbid obesity. Substituting leptin with metreleptin is a treatment option for these patients.</p><p><strong>Case presentation: </strong>We present the case of a patient with morbid obesity due to a single mutation in the LEP gene and approximately four years of treatment with metreleptin as a substitute therapy. Weight decreased from 154 to 64 kg and BMI decreased from 68.4 to 28.4 kg/m².</p><p><strong>Conclusions: </strong>The patient achieved a reduction of 40 kg/m2 in BMI, corresponding to a body weight loss of 90 kg, with a significant improvement in associated metabolic comorbidities, acne, and hirsutism.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors related to reversal of prediabetes in patients from a cardiovascular risk program during 2019 - 2023.","authors":"Wilfredo Antonio Rivera-Martínez, Aura María Salazar-Solarte, Diana Marcela Sánchez-Machado, Lunévar Figueroa Torregrosa, Robinson Pacheco, Yesit Bolaños-Moreno, María Eugenia Casanova-Valderrama","doi":"10.1186/s40842-025-00224-w","DOIUrl":"10.1186/s40842-025-00224-w","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) impacts the development of cardiovascular disease. Prediabetes, called intermediate hyperglycemia, is diagnosed with glucose levels that do not meet the criteria for T2DM, but are elevated. Lifestyle changes achieve a reversal of up to 58%, structured within an adequate follow-up in cardiovascular risk programs.</p><p><strong>Methodology: </strong>Longitudinal, descriptive study, with analytical scope, retrospective collection of information from a cohort of adults with a diagnosis of prediabetes; in quarterly follow-up by a cardiovascular risk program of a III level institution between 2019 - 2023. Univariate and bivariate analysis and logistic regression were performed to define the correlation between reversion to normoglycemia and associated factors.</p><p><strong>Results: </strong>Mean age was 69.5 years (SD 10.1), 50.8% women, median follow-up 366 days (IQR 249 - 569). Performing physical activity > 150 minutes per week (validated by International Physical Activity Questionnaire - IPAQ), increases 4.15 times the chance of reversing prediabetes (p< 0.001); while decreasing the chance of reversal, having an HbA1c ≥ 6.0 to 86% (p= 0.014) and BMI ≥ 25 to 75% (p= 0.005).</p><p><strong>Conclusions: </strong>Follow-up in structured cardiovascular risk programs allows estimating factors related to prediabetes reversion and emphasizing strategies to reduce comorbidities. Population-based studies are required to expand the results.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolomic signatures in adults with metabolic syndrome indicate preclinical disruptions in pathways associated with high-density lipoprotein cholesterol, sugar alcohols.","authors":"K A Lewis, Benjamin M Stroebel, Alka M Kanaya, Bradley Aouizerat, Kayla D Longoria, Elena Flowers","doi":"10.1186/s40842-025-00223-x","DOIUrl":"10.1186/s40842-025-00223-x","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome is a pressing public health issue and risk factor for the development of type 2 diabetes (T2D) and cardiovascular disease (CVD), yet clinical practice is lacking in biomarkers that represent pre-clinical perturbations of the heterogenous subtypes of risk. This study aimed to characterize the baseline metabolome in relation to known clinical characteristics of risk in a sample of obese adults.</p><p><strong>Methods: </strong>Untargeted metabolome data from N = 126 plasma samples with baseline data from a previously completed study including obese adults with metabolic syndrome. Metabolites were acquired using validated liquid chromatography mass spectrometry methods with 15-25 internal standards quantified by peak heights. Pearson's correlations were used to determine relationships between baseline metabolites, sample characteristics (e.g., age, body mass index (BMI)), and atherosclerotic clinical characteristics (e.g., high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides), adjusting for multiple comparisons using the Benjamini-Hochberg False Discovery Rate (FDR) method. Differences in metabolite levels between clinical classifications of dysglycemia (e.g., normal, prediabetes, diabetes) at baseline were assessed using ANOVA and adjusted for multiple comparisons and adjusted for covariates.</p><p><strong>Results: </strong>The sample consisted primarily of female (74%) participants, predominantly white (70%), with an average age of 56 years. After FDR adjustment, two baseline metabolites were significantly associated with age (xylose, threitol), two with BMI (shikimic acid, propane-1,3-diol), one with LDL (tocopherol-alpha), and 42 with HDL cholesterol. Three metabolites were significantly associated with fasting blood glucose (FBG) levels at baseline (glucose, gluconic acid lactone, pelargonic acid).</p><p><strong>Conclusions: </strong>This study identified novel metabolite associations with known markers of T2D and CVD risk. Specific metabolites, such as alpha-tocopherol, branched-chain amino acids (BCAAs), and sugar-derived metabolites like mannose and xylose, were significantly associated with age, BMI, lipid profiles, and glucose measures. Although most sample participants had normal HDL cholesterol at baseline, 42 metabolites including branched chain amino acids were significantly associated with HDL, suggesting pre-clinical perturbations in biological pathways associated with both diabetes and cardiovascular comorbidities. Metabolomic signatures specific to prediabetes and metabolic syndrome can enhance risk stratification and enable targeted prevention strategies for T2D. Longitudinal studies are needed to understand how these associations change over time in at-risk individuals compared with controls.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bromocriptine in type 2 diabetes: a promising alternative, a systematic review and meta-analysis.","authors":"Tahereh Dara, Mohsen Zabihi, Farahnaz Hoseinzade, Mahyar Rohani, Fatemeh Saghafi","doi":"10.1186/s40842-025-00222-y","DOIUrl":"10.1186/s40842-025-00222-y","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus is a chronic condition driven by insulin resistance and impaired beta-cell function. As beta cells gradually lose function, blood glucose levels rise, leading to clinical diabetes. This condition also elevates the risk of cardiovascular complications. Treatment typically requires multiple medications with different mechanisms of action. Recent developments include bromocriptine, a dopamine agonist approved by the Food and Drug Administration (FDA) for type 2 diabetes, which has been shown to reduce plasma glucose, triglycerides, and free fatty acid levels. To deepen our understanding of type 2 diabetes and refine treatment approaches, a comprehensive analysis of clinical studies and related data is essential.</p><p><strong>Methods: </strong>This systematic review and meta-analysis investigated the efficacy of bromocriptine in diabetes outcomes by analyzing randomized clinical trials (RCTs) in English up to November 25, 2024. The comprehensive search spanned Scopus, PubMed, and Web of Science, with additional studies identified through supplementary web searches and reference list checks. Inclusion criteria required clinical trials with clear methodologies and defined drug dosages. Data extraction gathered information on study design, outcomes, and intervention specifics, with quality assessment using the JADAD scoring system. Statistical analysis focused on standard mean difference (SMD), while the I² statistic measured study heterogeneity. A funnel plot analysis was employed to identify publication bias, with all analyses conducted using Comprehensive Meta-Analysis and Stata software.</p><p><strong>Results: </strong>Eighteen RCTs were conducted, revealing that dopamine D2 agonists have a relatively strong impact on reducing Hemoglobin A1C (HbA1c) and fasting blood sugar (FBS). However, with I² values of 96% for HbA1c and 99% for FBS, the results show high heterogeneity among the studies.</p><p><strong>Conclusions: </strong>Bromocriptine presents a promising alternative for individuals with diabetes who cannot tolerate conventional medications. Its unique mechanism of action might offer relief to those who suffer from side effects associated with standard treatments, providing a novel way to manage blood sugar levels.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DPP4 inhibitors and COVID19 outcomes in patients with type II diabetes: a multicenter retrospective cohort study in Saudi Arabia.","authors":"El Walid El Hassan, Ahmad Alamer, Sarah Saad Alnami, Ibrahem Abdullah Alhawaj, Ali Hussain Alsmail, Mohammed Abdulhadi Alshawaf, Muhammad Abdulhaddi Aljazeeri, Maram Jafar Alghafli, Fatimah Yahya Alhejji, Osamah M Alfayez, Mayar Mohammed Alharthi, Hamzah Redha Alturfi, Maha Fahad AlEssa, Rahaf Hamoud Alzuman, Sawsan M Kurdi, Omar A Almohammed, Abdulaziz S Almulhim, Majed S Al Yami","doi":"10.1186/s40842-025-00221-z","DOIUrl":"10.1186/s40842-025-00221-z","url":null,"abstract":"<p><p>Dipeptidyl peptidase-4 inhibitors (DPP-4is) have been hypothesized to impact COVID-19 outcomes by modulating immune and inflammatory responses. This study aimed to assess the association between DPP-4i use and COVID-19 severity in patients with type 2 diabetes. Adult (≥ 18 years) patients with T2DM hospitalized for COVID-19 across seven hospitals in Saudi Arabia between March 2020 and November 2021 were included. Outcomes were in-hospital mortality, progression to mechanical ventilation (MV), intensive care unit (ICU) admission, and length of stay. We performed time-to-event analyses using Cox proportional hazards models with propensity score weighting to account for confounders. Ordinal proportional odds model were for the length of stay outcomes. A total of 166 patients were included in the DPP-4i group, and 351 were included in the non-DPP-4i group. Propensity score weighting achieved a well-balanced comparison between the groups. The DPP-4i group showed a nonsignificant decrease in mortality (adjusted hazard ratio [HRadj] = 0.73; 95% confidence interval [CI]: 0.40-1.34; p = 0.319), a significant reduction in progression to MV (HRadj = 0.40; 95% CI: 0.21-0.77; p = 0.006), and a nonsignificant reduction in ICU admissions (HRadj = 0.83; 95% CI: 0.57-1.21; p = 0.338). Length of stay did not differ significantly between groups. This study revealed that prior usage of DPP-4is in T2DM patients with COVID-19 is linked to a significant reduction in progression to MV in this high-risk group. However, there is a need for further investigation through well-powered prospective studies and randomized controlled trials to confirm these findings.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diazoxide as a bridging therapy in methadone-induced hypoglycemia- a case report and review of the literature.","authors":"Katherine I Wolf, Sophia Hemmrich Sinha, Shafaq Khairi, Eric D Buras","doi":"10.1186/s40842-025-00220-0","DOIUrl":"10.1186/s40842-025-00220-0","url":null,"abstract":"<p><strong>Background: </strong>The objective of this report is to describe the successful use of diazoxide as a bridging therapy for a patient with opioid-induced hypoglycemia who was unable to immediately discontinue methadone treatment.</p><p><strong>Case presentation: </strong>A 41-year-old male presented for an unrelated planned surgical procedure and was found to have symptomatic hyperinsulinemic hypoglycemia resulting from high-dose methadone prescribed for chronic pain in the setting of end stage renal disease requiring hemodialysis. Diazoxide was successfully used as a bridging therapy until he ultimately decided to discontinue methadone following a multidisciplinary discussion with endocrinology, internal medicine, and an addiction consultation team. During a 10-day admission for safety and observation of withdrawal, he was weaned from methadone and transitioned to buccal buprenorphine and eventually sub-lingual buprenorphine/naloxone. After methadone was decreased and then discontinued, he was able to discontinue dextrose infusion and eventually diazoxide. Several months after discharge, he reported fasting blood glucose levels between 110 and 130 mg/dL (6.11-7.22 mmol/L; reference range 75-115 mg/dL; 4.16-6.38 mmol/L) without symptoms of hypoglycemia.</p><p><strong>Conclusions: </strong>While diazoxide has been used as bridging therapy for insulinoma patients awaiting surgery, this report highlights the utility of the non-diuretic benzothiadiazine in opioid-induced hyperinsulinemic hypoglycemia. Patients with hyperinsulinemic hypoglycemia on high doses of tramadol or methadone should be transitioned off the offending agent; however, diazoxide is an effective, alternative option when the transition is not feasible or needs to be delayed.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An 18-year Odyssey: navigating the complex path of prolactinoma management: a case report.","authors":"Firdhous Alimathunisa Abdul Kather, Ariel Barkan, Shafaq Khairi","doi":"10.1186/s40842-025-00218-8","DOIUrl":"10.1186/s40842-025-00218-8","url":null,"abstract":"<p><strong>Background: </strong>Prolactinomas are the most common type of pituitary adenomas, typically managed with dopamine agonists. However, some cases are refractory to standard therapies, posing significant clinical challenges. This case highlights the complexities of managing an aggressive macroprolactinoma resistant to conventional treatments and explores the use of immunotherapy as a novel intervention.</p><p><strong>Case presentation: </strong>A 54-year-old male with a history of hypertension and type 2 diabetes mellitus presented with erectile dysfunction and low libido, leading to a diagnosis of prolactinoma. Over an 18-year period, he underwent multiple interventions, including cabergoline therapy, four transsphenoidal surgeries, radiation therapy, and various pharmacotherapies. Despite these, he had refractory disease with markedly elevated prolactin levels and tumor growth. In the final stages of the disease, pembrolizumab immunotherapy was attempted. Unfortunately, the patient's condition continued to deteriorate, ultimately leading to hospice care and death at the age of 71.</p><p><strong>Conclusions: </strong>This case underscores the challenges associated with managing refractory prolactinomas and highlights the need for innovative therapeutic strategies, including immunotherapy. Further research is essential to establish the role of emerging treatments in improving outcomes for patients with aggressive pituitary adenomas.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11984238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of liraglutide biosimilar vs. reference liraglutide on weight reduction in T2DM patients with obesity: post hoc analysis of phase III trial.","authors":"Sujoy Ghosh, Bipin Sethi, Sanjay Kalra, Manash P Baruah, Abhishek Mane, Sanjay Choudhari, Anup Petare, Mayur Jadhav, Saiprasad Patil, Hanmant Barkate","doi":"10.1186/s40842-025-00219-7","DOIUrl":"10.1186/s40842-025-00219-7","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a chronic metabolic disease of global concern, often associated with Type 2 Diabetes Mellitus (T2DM). Global guidelines recommend holistic approach for T2DM management by addressing the associated comorbidities. Here, we have conducted a post-hoc evaluation of Liraglutide biosimilar Phase III trial on weight reduction and glycaemic benefits in Indian T2DM patients with obesity in comparison to reference liraglutide.</p><p><strong>Methods: </strong>We have conducted a post-hoc analysis of Liraglutide biosimilar Phase III trial on weight reduction in Indian T2DM patients with obesity in comparison to reference liraglutide. We evaluated weight reduction and HbA1c improvement in Indian T2DM patients (BMI > 25 kg/m²) from baseline to week 24. Group A - Intervention arm: Liraglutide Biosimilar in T2DM patients with obesity Group B - Control arm: Reference Liraglutide in T2DM patients with obesity. Primary endpoint was mean change in body weight from baseline to week 24.</p><p><strong>Results: </strong>179 T2DM patients (BMI > 25 Kg/m² and above) who satisfied the inclusion criteria, were included in this post-hoc analysis. The mean BMI of T2DM patients with obesity in Biosimilar Liraglutide arm was 29.8 ± 4.6 kg/m² and that in the Reference Liraglutide arm it was 29.8 ± 4.8 kg/m². Significant mean weight reduction (Mean ± SD) of 5.5 ± 1.2 kg (7.3 ± 1.7%) and 7.1 ± 2.6 kg (8.9 ± 1.7%) (p < 0.001) was demonstrated by both biosimilar liraglutide and reference liraglutide respectively. However, weight reduction was comparable across both the groups at week 24 (p = 0.71). Likewise, glycaemic parameters (HbA1c, FPG and PPG) significantly improved in both the treatment arms (p < 0.001). However, they were comparable across the groups at week 24 with a p value of 0.89, 0.43 and 0.17 for HbA1c, FPG and PPG respectively.</p><p><strong>Conclusion: </strong>Biosimilar Liraglutide at a dose of up to 1.8 mg was non-inferior to reference Liraglutide and resulted in significant weight reduction and glycemic control (HbA1c, FPG and PPG) in Indian T2DM patients with obesity.</p>","PeriodicalId":521069,"journal":{"name":"Cardiovascular diabetology. Endocrinology reports","volume":"11 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}