TouchREVIEWS in endocrinology最新文献

{"title":"Efficacy and Safety of Oral Semaglutide in the Management of Diabetes and Obesity: A Comprehensive Meta-analysis of Real-world Evidence.","authors":"Sweekruti Jena, Radhika Jindal, Deep Dutta, Abul Bashar Mohammad Kamrul-Hasan, Kunal Mahajan","doi":"10.17925/EE.2026.22.1.8","DOIUrl":"10.17925/EE.2026.22.1.8","url":null,"abstract":"<p><strong>Background: </strong>Oral semaglutide is the only oral glucagon-like peptide-1 receptor agonist approved for type 2 diabetes (T2D) management. Although its efficacy and safety are established from randomized controlled trials (RCTs), real-world evidence (RWE) may differ. No comprehensive systematic review and meta-analysis (SRM) has holistically analysed the RWE on oral semaglutide. This SRM analysed the RWE outcomes of oral semaglutide.</p><p><strong>Methods: </strong>Electronic databases were searched for real-world studies reporting outcomes in adults with T2D receiving oral semaglutide. Primary outcomes were changes in glycated haemoglobin (HbA1c) at 6 and 12 months. Secondary outcomes included changes in body mass index, blood pressure, lipids and adverse events (AEs). Subgroup analyses compared outcomes between Asian and non-Asian cohorts.</p><p><strong>Results: </strong>A total of 59 studies (24,859 individuals) were analysed. The pooled mean HbA1c reduction was -1.11% (95% confidence interval: -1.37 to -0.86; I²=98.8%) at 6 months and -1.19% at 12 months, with 54.7% achieving HbA1c <7%. Weight reduction averaged -4.38 kg at 6 months and -5.96 kg at 12 months. Significant improvements were observed in cardiometabolic parameters. The pooled prevalence of total AEs, gastrointestinal AEs, nausea, diarrhoea and hypoglycaemia was 28.9%, 20.5%, 12.5%, 5.9% and 2.2%, respectively. Discontinuation and dose reduction due to AEs occurred in 8.7% and 4.2% of patients, respectively. Efficacy and safety outcomes were consistent across regions (p for subgroup >0.05).</p><p><strong>Conclusion: </strong>Oral semaglutide demonstrates robust real-world efficacy and safety in T2D and obesity management, similar to RCTs, consistent across Asian and non-Asian populations.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"16-28"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220930","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":"Burosumab for X-linked Hypophosphataemia and Tumour-induced Osteomalacia in Adults.","authors":"Simon Black, Richard Keen, Judith Bubbear","doi":"10.17925/EE.2026.22.1.6","DOIUrl":"10.17925/EE.2026.22.1.6","url":null,"abstract":"<p><p>X-linked hypophosphataemia and tumour-induced osteomalacia are rare, distinct metabolic conditions that can affect both children and adults, and result in elevated fibroblast growth factor-23 levels and subsequent low phosphate levels. This leads to severe musculoskeletal symptoms and complications, and these conditions carry significant disease burden and high levels of morbidity. In this article, we examine the conditions and analyse the use of burosumab, a recently developed monoclonal antibody treatment, in the care of adults with these conditions.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220903","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":"Obesity, Metabolic Syndrome, Diabetes and Kidney Stones: Strengthening Links Over Time?","authors":"Ides M Colin, Agnieszka Pozdzik","doi":"10.17925/EE.2026.22.1.7","DOIUrl":"10.17925/EE.2026.22.1.7","url":null,"abstract":"<p><p>Long considered separate entities, obesity/type 2 diabetes/metabolic syndrome and kidney stone disease are now recognized as interconnected conditions, both from an epidemiological and pathophysiological perspective. Although the pathophysiological mechanisms between visceral obesity, metabolic syndrome and type 2 diabetes are well established, the link with an increased propensity to develop kidney stones may appear less clear at first glance. Over the past decade, data from retrospective analyses and prospective cohort studies have clarified the nature and the magnitude of this relationship. The common threads linking these pathophysiological entities, apparently distinct at first sight, are insulin resistance and systemic low-grade inflammation, which should be considered as the unifying pathological roots. Within the kidney, higher urinary levels of oxalate, calcium and uric acid, combined with a fall in urine pH, increase supersaturation of lithogenic salts. If unopposed, this physicochemical imbalance drives crystal nucleation, growth and aggregation, leading to precipitation of insoluble salts and, ultimately, to stone formation. This narrative review presents epidemiological and pathophysiological evidence that helps understand the extent to which seemingly unrelated conditions are, in fact, part of a broader metabolic disorder, the cardiovascular-kidney-metabolic syndrome, in which kidney stone disease can likely be integrated because common pathophysiological features are shared. The question then arises as to whether weight loss and modern treatments for type 2 diabetes, in particular glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors, influence the lithogenic risk.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220870","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":"Rethinking Metabolic Dysfunction in Chronic Liver Diseases.","authors":"Lung-Yi Loey Mak","doi":"10.17925/EE.2026.22.1.5","DOIUrl":"10.17925/EE.2026.22.1.5","url":null,"abstract":"<p><p>Metabolic dysfunction is a concept derived from metabolic syndrome, which is characterized by the presence of metabolic abnormalities, including obesity, diabetes mellitus, hypertension and dyslipidaemia. Metabolic dysfunction not only drives the development of metabolic dysfunction-associated steatotic liver disease but is also responsible for the heightened cardiovascular risk within the broader scope of liver-cardiovascular-kidney-metabolic syndrome. In other chronic liver diseases, metabolic dysfunction alters the natural history and might impact treatment outcomes.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220996","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":"Beyond A1c: Redefining Evidence and Policy to Advance Therapies in Type 1 Diabetes Care.","authors":"Huajing Ni, Jerry R Greenfield, Jennifer R Snaith","doi":"10.17925/EE.2026.22.1.4","DOIUrl":"10.17925/EE.2026.22.1.4","url":null,"abstract":"<p><p>Innovation in technology has revolutionized modern-day type 1 diabetes (T1D) care, significantly improving glycaemic control and the patient experience. However, the outcome measures used in clinical trials, which inform policies, remain stagnant. Progress has been made in the search for adjunctive therapies beyond insulin to reduce residual cardiometabolic risk. The importance of patient-centred strategies is also increasingly recognized. The future of T1D research calls for the adaptation by regulators to accept additional endpoints beyond haemoglobin A1C (HbA1c).</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220763","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 CKD-OSTEO Score: A Chronic Kidney Disease-specific Tool for Osteoporosis Risk Stratification.","authors":"Sourabh Sharma, Sanjay Kalra, Nitin Kapoor, Lakshmi Nagendra, Ashish Jaiman, Sree Bhushan Raju","doi":"10.17925/EE.2026.22.1.2","DOIUrl":"10.17925/EE.2026.22.1.2","url":null,"abstract":"<p><p>Osteoporosis in patients with chronic kidney disease (CKD) frequently goes undiagnosed and is not treated adequately, largely due to its intricate pathophysiology and the lack of risk stratification tools specific to CKD. Standard tools used for the general populace, such as the Fracture Risk Assessment Tool (FRAX) score and bone mineral density-based thresholds, fail to accurately represent the unique biochemical and structural bone alterations that take place in CKD stages IIIb-VD. We propose the Chronic Kidney Disease Osteoporosis Stratification Tool for Evaluation and Optimization (CKD-OSTEO) score, an innovative multidimensional clinical tool intended to evaluate the risk of osteoporosis, direct diagnostic assessments and inform suitable treatment strategies for patients with CKD. This score integrates conventional fracture risk factors with CKD-specific components, such as dialysis vintage, intact parathormone levels, serum Klotho levels and T-scores. We explain the pathophysiological rationale for each element, categorize patients into various management levels and provide customized recommendations for starting and selecting anti-resorptive therapy. Emphasis is placed on the growing importance of Klotho deficiency as a marker of bone-vascular ageing. With this article, we advocate for the regular risk stratification of patients with CKD to enhance fracture prevention, tailor treatment strategies and incorporate new biomarkers like Klotho into practice.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221102","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":"Pragmatic Use of Thyroid Autoantibodies in Clinical Practice: An Update.","authors":"Naima Parveen, Sachin Chittawar, Deepak Khandelwal, Sameer Aggarwal","doi":"10.17925/EE.2026.22.1.3","DOIUrl":"10.17925/EE.2026.22.1.3","url":null,"abstract":"<p><p>Autoimmune thyroid diseases, encompassing Hashimoto's thyroiditis and Graves' disease, are driven by immune-mediated targeting of thyroid antigens. Central to their diagnosis and management is the detection of circulating thyroid autoantibodies (TAbs), particularly those against thyroid peroxidase (TPO), thyroglobulin (Tg) and the thyrotropin receptor (TR). These antibodies have traditionally served as disease markers, but emerging evidence underscores their functional roles in pathogenesis, prognostication and therapeutic decision-making. For example, TR antibodies not only confirm the diagnosis of Graves' disease but also help assess disease activity, predict treatment response and evaluate foetal risk during pregnancy. Similarly, TPO and Tg antibodies contribute to the identification of subclinical thyroid dysfunction and have implications for reproductive health and immune-related adverse events from biologic therapies. Newly identified antibodies targeting molecules, such as pendrin, sodium-iodide symporter and megalin, suggest a broader autoimmune footprint than previously recognized. However, their clinical relevance remains to be fully elucidated. The interpretation of TAb is further complicated by assay variability, dynamic antibody titres and their presence in euthyroid individuals, particularly in special populations such as pregnant women, children and those with other autoimmune disorders. This article synthesizes current insights into the immunological basis, diagnostic performance and clinical applications of TAb. It emphasizes the need for a pragmatic, context-specific approach to testing, advocating for a more tailored integration of antibody data into clinical decision-making. By aligning immunologic knowledge with real-world practice, this article aims to refine the utility of TAb in contemporary endocrine care.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220971","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":"Utility of Surrogate Markers for Insulin Resistance: Homeostasis Model Assessment for Insulin Resistance (HOMA-IR) and Triglyceride-Glucose (TyG) Index in Identifying Metabolic Syndrome Among Adults from Resource-limited Settings.","authors":"Ruchita Chauhan, Shilpa Jain, Neeta Malukar, Jaya Pathak, Maitri Ajmera, Shubham Mishra, Madhur Verma","doi":"10.17925/EE.2026.22.1.1","DOIUrl":"10.17925/EE.2026.22.1.1","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) is a central feature of metabolic syndrome (MetS). While the homeostasis model assessment for insulin resistance (HOMA-IR) is widely used, it has limitations in resource-constrained settings. The triglyceride-glucose (TyG) index offers a simpler alternative, but comparative data from Indian adults are limited. This study aimed to evaluate and compare the performance of the two indices as surrogate markers for IR among adults.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted among 312 adults (217 without MetS and 95 with MetS), selected using stratified random sampling. Participants underwent standardized anthropometric measurements and fasting biochemical tests. MetS was defined according to the International Diabetes Federation (IDF) criteria. HOMA-IR and TyG indices were calculated and compared across demographic and clinical subgroups. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Participants with MetS had significantly higher HOMA-IR and TyG index values compared with those without MetS (p<0.001). Both indices showed a strong positive correlation with metabolic parameters. ROC analysis revealed that the TyG index had superior diagnostic performance (area under the curve [AUC]=0.85) compared with HOMA-IR (AUC=0.81). The TyG index also showed greater sensitivity (68.4% versus 64.2%), specificity (94.0% versus 89.4%) and overall accuracy (86.2% versus 81.7%).</p><p><strong>Conclusions: </strong>Both HOMA-IR and the TyG indices are useful in identifying IR; however, the latter demonstrated better overall diagnostic accuracy and greater practicality. Given its ease of calculation and cost-effectiveness, the TyG index may be a suitable screening tool for IR in low-resource environments. Further longitudinal validation studies are warranted.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"22 1","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13249129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221056","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":"Association Between Anthropometry and Cognitive Impairment in Patients with Type 2 Diabetes: Secondary Analysis from the 'Cognition in Diabetes' Study.","authors":"Subhankar Chatterjee, Rana Bhattacharjee, Animesh Maiti, Moumita Mondal, Subir Hait, Souvik Dubey","doi":"10.17925/EE.2025.21.2.7","DOIUrl":"10.17925/EE.2025.21.2.7","url":null,"abstract":"<p><p>With an ageing global population, the triad of type 2 diabetes (T2D), obesity and dementia poses a growing public health challenge. India harbours a notable proportion of younger patients with T2D with a non-obese or lean phenotype. However, data remain scarce on the impact of adiposity on cognition in T2D, particularly when assessed using a comprehensive, culturally and linguistically adaptable cognitive battery in a cohort free from major confounding factors. The aim of this study is to examine the relationship between various anthropometric indices and cognitive performance in patients with T2D. This cross-sectional observational study was conducted at the diabetic clinic of a tertiary hospital from 2022 to 2024. Eligible participants were patients with T2D aged 20-60 years with at least primary education. Exclusion criteria included non-T2D diagnosis, inability to communicate in Bengali and conditions known to impair cognition. A total of 125 patients with T2D were recruited. Demographics, diabetes-related variables and anthropometric measurements were recorded. Cognitive function was assessed using the Bengali version of the Addenbrooke's Cognitive Examination (ACE-III). Statistical analysis was performed using Jeffreys' Amazing Statistics Program (v.0.19). ACE-III total scores showed significant positive correlations with height, weight and neck circumference (NC) (p<0.001 for each). Attention was positively associated with height, weight, NC, neck-height ratio (NHR) and negatively with weight-adjusted waist index (WWI) (p<0.05 for all). Memory correlated positively with height and weight (p<0.05 for both). Language was positively related to height, weight and NC (p<0.05 for all) and negatively to WWI (p=0.011). Visuospatial ability positively correlated with height, weight, waist circumference (WC), hip circumference (HC), NC and NHR (p<0.05 for all). Lean patients with T2D had significantly lower visuospatial scores (p=0.040), lower ACE-III total scores (p=0.049) and a greater prevalence of cognitive impairment (p=0.032). In multiple linear regression, height (p=0.014) and HC (p=0.024) were independent predictors of ACE-III total score. This is the first Indian study to evaluate the association between anthropometric measures and cognition in T2D. Cognitive impairment and dementia were more prevalent in lean than in obese patients with T2D. Future studies incorporating imaging-based body composition analysis are warranted to identify modifiable anthropometric risk factors for cognitive decline in T2D.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544144","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":"A Clinical Review of Continuous Glucose Monitoring in the Hospital Setting.","authors":"Jennifer N Clements, Kennedy Howard, Emory Moss","doi":"10.17925/EE.2025.21.2.3","DOIUrl":"10.17925/EE.2025.21.2.3","url":null,"abstract":"<p><p>This editorial explores the critical role of continuous glucose monitoring (CGM) in managing diabetes within hospital settings. It provides a comprehensive clinical overview of CGM technology, highlighting its advances, such as improved glucose control and reduced hypoglycaemic events. This article also delves into the challenges, including cost and integration with existing hospital systems. The editorial examines real-world applications of CGM, highlighting its potential to enhance patient outcomes and streamline diabetes care in hospitals. By addressing both the current state and prospects of CGM, this article underscores its value in advancing diabetes management and improving overall patient care in hospital settings.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544121","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}