TouchREVIEWS in endocrinology最新文献

{"title":"Foetal Metformin Exposure, Childhood Adiposity and Future Cardiovascular Risk: Can We Connect the Dots?","authors":"Simran Thakkar, Saptarshi Bhattacharya, Lakshmi Nagendra, Nitin Kapoor, Deep Dutta, Sanjay Kalra","doi":"10.17925/EE.2025.21.2.4","DOIUrl":"10.17925/EE.2025.21.2.4","url":null,"abstract":"<p><p>The prevalence of gestational diabetes (GD) and pre-existing diabetes during pregnancy has been increasing. Insulin is the accepted pharmacological treatment for hyperglycaemia in pregnancy. Metformin has emerged as a promising alternative or adjunct due to its ease of use, lower cost and reduced risk of hypoglycaemia. Beyond GD, metformin also shows potential utility in early GD and polycystic ovary syndrome. Current evidence suggests that using metformin in these settings does not raise short-term safety concerns. Some studies show that metformin reduces maternal weight gain and lowers the incidence of large-for-gestational-age (LGA) infants. Despite these benefits, the broader adoption of metformin is limited by concerns about its ability to cross the placenta, resulting in foetal concentrations comparable to maternal levels. <i>In utero</i> exposure to metformin has been shown to induce mitochondrial and epigenetic alterations in animal and <i>ex vitro</i> studies. These changes have been linked to childhood obesity, altered adiposity markers and future cardiovascular disease (CVD) risk. Both LGA and small-for-gestational-age (SGA) neonates have an increased risk of future CVD. Metformin may offer protection by reducing the incidence of LGA births; however, an increase in SGA rates, reported in some studies, could offset this potential benefit. SGA infants who experience rapid catch-up growth are particularly vulnerable. It remains unclear whether the altered growth trajectory in offsprings of metformin-treated mothers increases future CVD risk. The final risk likely reflects a multifactorial interaction involving maternal metabolic status, degree of glycaemic control, placental function, the mitigating effect of metformin on LGA, and a predisposition to SGA and childhood adiposity. Longitudinal prospective studies are essential to understand the long-term cardiovascular implications of foetal metformin exposure. Applying precision medicine to identify women likely to benefit from metformin, offers a rational strategy to optimize pregnancy outcomes.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"15-25"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544138","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":"Metabolic Syndrome in Older Adults: When Function Trumps Numbers.","authors":"Marcio José Concepción-Zavaleta, Eduardo Cabellos-Acuña, Jenyfer Maria Fuentes-Mendoza, José Paz-Ibarra","doi":"10.17925/EE.2025.21.2.6","DOIUrl":"10.17925/EE.2025.21.2.6","url":null,"abstract":"<p><p>This editorial critiques the limitations of traditional metabolic syndrome criteria in older adults, arguing that age-related changes in body composition, vascular stiffness and frailty render standard thresholds inadequate. Highlighting the 'obesity paradox' and risks of intensive blood pressure/lipid control, the article advocates for a frailty-centred approach integrating functional status, body composition (e.g. dual-energy X-ray absorptiometry) and inflammation markers over rigid numerical targets. Practical strategies include sarcopenia screening (SARC-F), resistance training and individualized glycaemic/blood pressure goals to avoid overtreatment in frail patients. The paradigm shift aims to improve risk stratification and align care with geriatric priorities.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544180","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":"Bridging Medical Specialities in the Management of Polycystic Ovary Syndrome: Integrating Lessons from Sodium-glucose Cotransporter-2 Inhibitors into a Holistic Approach.","authors":"Taieb Ach, Feryel Amri, Houcem ElOmma Mrabet","doi":"10.17925/EE.2025.21.2.1","DOIUrl":"10.17925/EE.2025.21.2.1","url":null,"abstract":"<p><p>Polycystic ovary syndrome presents significant metabolic, dermatologic and gynaecologic challenges, including hyperandrogenism, menstrual irregularities and obesity. While patients often consult different specialists for dermatologic or gynaecologic concerns, effective management requires placing metabolic health at the centre of all specialities involved; from endocrinology to nutrition. Traditional boundaries between specialities are fading, creating a more unified approach focused on metabolic management. This centralization fosters comprehensive strategies to address both immediate symptoms and long-term risks, leading to improved, holistic patient outcomes.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"9-11"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544141","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":"Dual GIP/GLP1-RA, GCGR/GLP-1 RA and GLP1-RA for the Treatment of Metabolic Dysfunction-associated Steatotic Liver Disease with Type 2 Diabetes: A Systematic Review and Meta-analysis.","authors":"Burhan Gunawan, Heri Nugroho, Roy Panusuan Sibarani","doi":"10.17925/EE.2025.21.2.5","DOIUrl":"10.17925/EE.2025.21.2.5","url":null,"abstract":"<p><p>Previous studies have revealed that glucagon-like peptide-1 receptor agonist (GLP-1RA) can improve metabolic dysfunction-associated steatotic liver disease (MASLD) in individuals with type 2 diabetes (T2D). However, comprehensive research comparing dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1RA, glucagon receptor (GCGR) agonist/GLP-1RA and GLP-1RA is limited. This meta-analysis aimed to summarize the current evidence for the efficacy and safety of dual GLP/GIP-1RA, GCGR/GLP-1RA and GIP-1RA for these individuals. PubMed, Web of Science, Scopus and the Cochrane database were searched for randomized controlled trials that explore the efficacy of dual GIP/GLP-1RA, GCGR/GLP-1RA or GLP-1Ras for MASLD and T2D. The outcomes were the reversal of liver fibrosis degree and liver fat content (LFC) calculated using magnetic resonance imaging scan. The random-effects model was used to calculate the mean difference (MD) and odds ratio (OR) with a 95% confidence interval (CI). Thirteen studies with a total pooled sample of 1,552 individuals were included in the study. Dual GIP/GLP-1RA, GCGR/GLP-1RA and GLP-1RA were significantly superior in reversing the liver fibrosis degree (OR 3.72; 95% CI: 2.72, 5.09; p<0.001) and decreasing the LFC (MD -18.90; 95% CI: -18.43, -19.37; p<0.001) compared with other active therapies or placebo. Dual GIP/GLP-1RA (OR 28.90) and GCGR/GLP-1RA (OR 35.31) have greater efficacy in the reduction in LFC than single GLP-1RA (OR 8.23). Medications combining GIP/GLP-1RA and GCGR/GLP-1RA could be beneficial for individuals with both T2D and MASLD.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"26-32"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544172","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":"Advancing the Therapeutic Frontier in Thyroid Eye Disease.","authors":"Seyed Omid Mohammadi, Coby Ray","doi":"10.17925/EE.2025.21.2.2","DOIUrl":"10.17925/EE.2025.21.2.2","url":null,"abstract":"<p><p>Thyroid eye disease (TED), also known as Graves' orbitopathy, is driven by autoimmune processes that lead to orbital inflammation, oedema and potential vision loss. Traditional management includes high-dose intravenous corticosteroids, orbital radiotherapy and surgery. However, newer therapies, notably teprotumumab (a monoclonal antibody against the insulin-like growth factor I receptor), offer targeted immunomodulation with promising outcomes in reducing proptosis and improving symptoms. The future of TED treatment lies in further research on biologics, personalized approaches and continued multidisciplinary collaboration to optimize patient care.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 2","pages":"12-14"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12616671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544162","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":"Diabetes Care and Education: A Look Backward and Forward.","authors":"Linda M Siminerio, Youjia Wang, Denise Charron-Prochownik","doi":"10.17925/EE.2025.21.1.5","DOIUrl":"10.17925/EE.2025.21.1.5","url":null,"abstract":"<p><p>The importance of self-management and education is now generally known and accepted in the diabetes community. Despite this, the number of people with diabetes who receive diabetes education and psychosocial services continues to be disappointing. While clinical advances are being adopted, referrals to diabetes education remain low, and resources for behavioural support are scarce. This calls for a need to inform and remind care providers and healthcare decision-makers of the efforts of all those who built the foundation for comprehensive diabetes care, which continues to inform practice and serve as a backdrop for research to address today's challenges.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"5-8"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251247","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":"Role of Sodium-Glucose Cotransporter-2 Inhibitors in Managing Polycystic Ovary Syndrome: A Systematic Review.","authors":"Abm Kamrul-Hasan, Sunetra Mondal, Fatema Tuz Zahura Aalpona, Lakshmi Nagendra, Deep Dutta","doi":"10.17925/EE.2025.21.1.2","DOIUrl":"10.17925/EE.2025.21.1.2","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) can improve metabolic parameters and significantly reduce weight and fat mass. Evidence regarding the use of SGLT2i in polycystic ovary syndrome (PCOS) is limited. The current systematic review compared the efficacy of SGLT2i with placebo or other active comparators in PCOS.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) involving patients with PCOS who are overweight and obese and receiving SGLT2i as intervention and placebo or any non-hormonal comparator as controls were identified through electronic databases. The outcomes of interest included changes in metabolic, hormonal, anthropometric and body composition parameters.</p><p><strong>Results: </strong>Five RCTs involving 269 participants were included. Canagliflozin, empagliflozin, dapagliflozin and licogliflozin were studied either as monotherapy or in combination with metformin or exenatide. SGLT2i reduced insulin resistance, as evidenced by decreased homeostatic model assessment for insulin resistance and insulin and fasting plasma glucose levels. Reductions in body weight, body mass index, waist circumference and total body fat were observed with most of the SGLT2i. A reduction in dehydroepiandrosterone sulphate (DHEAS) levels was also observed in two RCTs, whereas a decrease in total testosterone level or free-androgen index was not associated with most SGLT2i. Improvements in menstrual irregularity and hirsutism scores were observed. Triglycerides were reduced, while low-density lipoprotein level was slightly increased with SGLT2i in most RCTs. Improvements in body composition and metabolic parameters were most prominent with a combination of SGLT2i with a glucagon-l ike peptide receptor-1 agonist (GLP1RA), while the combination of SGLT2i with metformin showed better effects on hormonal parameters. Adverse effects with SGLT2i were mostly mild and included genital infections.</p><p><strong>Conclusion: </strong>SGLT2i, when used as monotherapy or combined with metformin or GLP1RA, are a promising therapy for improving metabolic and hormonal parameters in PCOS.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"32-41"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251251","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 Use of Non-i nvasive Biomarkers to Screen for Advanced Fibrosis Associated with Metabolic Dysfunction-associated Steatotic Liver Disease in People with Type 2 Diabetes: A Narrative Review.","authors":"David M Williams, Jagadish Nagaraj, Jeffrey W Stephens, Thinzar Min","doi":"10.17925/EE.2025.21.1.4","DOIUrl":"10.17925/EE.2025.21.1.4","url":null,"abstract":"<p><p>There is growing interest in metabolic dysfunction-associated steatotic liver disease (MASLD), given its increasing prevalence and our developing understanding of the disease. People living with type 2 diabetes or obesity have a greater risk of developing significant hepatic steatosis and a greater risk of more rapid progression to steatohepatitis, advanced hepatic fibrosis and hepatocellular carcinoma. As such, various international bodies now advocate for routine screening for MASLD-related hepatic fibrosis in people with such risk factors. This would permit earlier targeted lifestyle interventions and the use of pharmacotherapies, which may reverse earlier stages of MASLD-associated fibrosis. This may improve both liver-related and cardiovascular outcomes in these higher-risk groups. Nonetheless, the identification of MASLD-related hepatic fibrosis is frequently limited to liver enzyme tests, given the lack of a systematic approach to investigation and screening. In this article, we discuss the potential to screen for advanced fibrosis in people with MASLD using various blood-based biomarkers, such as the Fibrosis-4 score, non-alcoholic fatty liver disease fibrosis score and enhanced liver fibrosis test, amongst other available patented and non-patented tests. We discuss the relative benefits and limitations of each and the potential for future research in this evolving area of clinical interest.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"24-31"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251261","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 Role of Remote Glucose Management Using Real-time Continuous Glucose Monitoring Systems in ICU-hospitalized Patients with COVID-19.","authors":"Georgios Logothetis, Konstantinos Avramidis, Evanthia Konstantaki, Vasiliki Matziou, John Doupis","doi":"10.17925/EE.2025.21.1.7","DOIUrl":"10.17925/EE.2025.21.1.7","url":null,"abstract":"<p><p>The recent coronavirus disease 2019 (COVID-19) pandemic has induced many challenges in the clinical environment worldwide. In a bid to reduce the exposure of healthcare providers to severe acute respiratory syndrome coronavirus 2 and the utilization of personal protective equipment (PPE), while maintaining optimal patient care, in April 2020, the US Food and Drug Administration issued a new policy, allowing the use of continuous glucose monitoring (CGM) systems in the intensive care unit (ICU) setting. This article aimed to explore the role of real-time continuous glucose monitoring systems in patients in the ICU with COVID-19. The hybrid protocols integrating real-time CGM and point of care seem to be a feasible and safe alternative for the glycaemic management of critically ill patients with COVID-1 9, including the reduction of healthcare providers' exposure and the preservation of PPE, whilst achieving and maintaining optimal glycaemic control.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251260","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":"Changes in Urinary Aquaporin 2 and Serum Sodium After Catheterization in Elderly Patients with Syndrome of Inappropriate Antidiuretic Hormone and Urinary Retention: A Preliminary Hospital-based Study in Yangon, Myanmar.","authors":"Than Than Aye, Mya Thanda Sein, Phyo Thiha, Tin Myo Han, Htar Ni Aye, Yin Thu Theint, Mie Mie Pyone, Kyaw Swar Thet, Thet Htun Zaw, Aye Moh Moh Han","doi":"10.17925/EE.2025.21.1.6","DOIUrl":"10.17925/EE.2025.21.1.6","url":null,"abstract":"<p><strong>Background: </strong>The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the most common electrolyte disorder among elderly patients. Chronic urinary retention has also been implicated in the development of SIADH. The mechanism by which urinary retention leads to SIADH remains unclear. Increased responsiveness of the collecting ducts to arginine vasopressin has been observed in elderly patients with urinary retention. This study aims to evaluate whether SIADH in elderly patients with urinary retention is associated with increased urinary aquaporin 2 (U-AQP2) levels and whether the insertion of an indwelling catheter with fluid restriction, without the administration of 3% saline, can lower the U-AQP2 level, leading to the resolution of SIADH.</p><p><strong>Method: </strong>This hospital-based clinical intervention study was conducted from January 2022 to January 2023. Eighteen elderly patients who met the selection criteria for euvolaemic SIADH (identified by Bartter and Schwartz criteria) associated with urinary retention, after excluding other causes, were selected. Serum sodium (Nas), serum osmolality (Osms), U-AQP2 levels, urinary osmolality (Osmu) and 24-hour urine volume on days 1 and 4 post-catheterization were assessed and compared. Clinical responses, including neurological signs and symptoms (Glasgow Coma Scale [GCS]), were also recorded.</p><p><strong>Results: </strong>All 18 cases had comorbidities and were in a range of severe hyponatraemia, defined as Nas<125 mmol/L. Nas levels significantly increased (p<0.05) on days 2 and 4 after the drainage of residual urine, with mean (± standard deviation) changes of 8.39 (± 5.7) and 15.67 (± 5.6) mmol/L, respectively, from a baseline of 110.7 mmol/L. Osms significantly increased (p<0.05) from 240.01 (± 15.68) mOsm/kg on day 1 to 272.74 (± 13.41) mOsm/kg on day 4 post-catheterization. The mean urinary aquaporin:creatinine ratio significantly decreased (p<0.05) from 3,348.01 (± 2,127.82) fmol/mg Cr on day 1 to 1,135.27 (± 1,194.42) fmol/mg Cr on day 4. The mean Osmu significantly decreased (p=0.00) from 450.67 (± 187.3) mOsm/kg on day 1 to 229.33 (± 123.56) mOsm/kg on day 4. The mean urine volume significantly increased (p<0.05) from 1,610.00 (± 530.15) mL on day 1 to 2,725.56 (± 898.29) mL on day 4. All patients showed neurological improvement, with the mean GCS increasing from 11 to 14, without complications of osmotic demyelination syndrome.</p><p><strong>Conclusion: </strong>U-AQP2 levels are elevated in elderly patients with SIADH with urinary retention. After catheterization, these levels decrease, leading to the spontaneous resolution of hyponatraemia without complications.</p>","PeriodicalId":75231,"journal":{"name":"TouchREVIEWS in endocrinology","volume":"21 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251246","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}