BMC Endocrine Disorders最新文献

{"title":"Incretin-based approaches for type 2 diabetes therapy: effects on circulating cytokines and adipocyte's secretome.","authors":"Margarita Agareva, Svetlana Michurina, Alina Tomilova, Ekaterina Shestakova, Anastasia Voznesenskaya, Maria Sineokaya, Ekaterina Zubkova, Elizaveta Ratner, Iurii Stafeev, Yelena Parfyonova, Marina Shestakova","doi":"10.1186/s12902-025-01999-w","DOIUrl":"https://doi.org/10.1186/s12902-025-01999-w","url":null,"abstract":"<p><strong>Background: </strong>Adipose tissue secretome plays a crucial role in the mechanisms of metabolic diseases. Weight loss has a favourable effect on the adipose tissue secretome and prevents the development of type 2 diabetes mellitus (T2DM) and its complications. The most effective methods of glycaemic control are bariatric surgery (BS) and pharmacotherapy. The aim of our study is to evaluate changes in adipose tissue secretome after BS and semaglutide injections.</p><p><strong>Methods: </strong>17 patients with T2DM were examined before and 6 months after BS or semaglutide therapy. The examination protocol included anthropometry, clinical biochemistry, insulin resistance evaluation and collection of subcutaneous adipose tissue biopsies. Adipose derived stem cells (ADSC) were isolated from biopsies according to a standard enzymatic protocol and differentiated into white and beige adipocytes. Adipogenesis and thermogenesis were assessed by confocal microscopy. Secretome of adipocytes and cytokines plasma levels were analyzed using a MILLIPLEX panel.</p><p><strong>Results: </strong>Following BS and semaglutide therapy, a decline in BMI, total fat content, HbA1c, and fasting blood glucose was observed. Insulin sensitivity increased only 6 months after BS. Semaglutide therapy resulted in the elevation of angiogenic and proinflammatory cytokines in adipocyte secretory profile. After BS we also detected the increase in proinflammatory cytokines both in adipocyte secretome and in plasma levels. However, the adipocyte secretome subsequent to bariatric surgery (BS) exhibited a reduced proinflammatory response in comparison to that observed following semaglutide therapy.</p><p><strong>Conclusions: </strong>The effect of semaglutide injections directly on adipose tissue can change the function of ADSC, making them more angiogenic and adipogenic. A decrease in BMI, HbA1c and insulin resistance is achieved to a significant extent only after BS. BS-induced T2DM remission is related to lower pro-inflammatory secretion from adipocytes as compared to semaglutide. The regulation of inflammation in adipocytes may serve as a potential mechanism underlying BS-induced T2DM remission.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"182"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of non-insulin anti-diabetic medications on the diabetic microvascular complications: a systematic review and meta-analysis of randomized clinical trials.","authors":"Song Wen, Yue Yuan, Yanyan Li, Chenglin Xu, Lijiao Chen, Yishu Ren, Congcong Wang, Yanju He, Xiucai Li, Min Gong, Xinlu Yuan, Dongxiang Xu, Chaoxun Wang, Ligang Zhou","doi":"10.1186/s12902-025-01985-2","DOIUrl":"10.1186/s12902-025-01985-2","url":null,"abstract":"<p><strong>Introduction: </strong>Although the onset and progression of diabetic microvascular complications are linked to glycemic control, various antihyperglycemic drugs with distinct treatment targets may positively impact microvascular lesions beyond their glucose-lowering effects. Therefore, this systematic review emphasizes the clinical therapeutic implications of non-insulin anti-diabetic medications for diabetic microvascular complications.</p><p><strong>Methods: </strong>We retrieved published literature reporting randomized clinical trials (RCTs) on the effects of microvascular complications, including diabetic nephropathy (DN), diabetic peripheral neuropathy (DPN), and diabetic retinopathy (DR), from authenticated clinical databases: PubMed, Excerpta Medica database (EMBASE), and Web of Science. We synthesized data, including the continuous variable indices: estimated glomerular filtration rate (eGFR), urinary albumin to creatinine ratio (UACR), and urinary albumin excretion rate (UAE). Indices measuring cardiovascular autonomic neuropathy (CAN), vibration detection threshold (VDT), and retinal nerve fiber thickness (RNFL) were used to calculate microvascular effects. We also synthesized dichotomous variable indices, including the risks for DR and DPN.</p><p><strong>Results: </strong>According to our analyses, there was sparse evidence strongly supporting that metformin (MET), Sulfonylurea (SUs), Repaglinide (Repa), or α-Glucosidase inhibitors (α-GIs) could benefit diabetic microvascular complications when adopted as monotherapy. Regardless of the no change in eGFR, two trials reporting Thiazolidinediones (TZDs) significantly reduced the UACR, while other clinical trials reported an increase in VDT and improvement in DR. Sodium glucose co-transporter inhibitors (SGLT-2i) and Glucagon-like peptide-1 receptor agonists (GLP-1RA) both showed protective effects in preventing eGFR decline, with only SGLT-2i demonstrating a significant reduction in UACR. A recent trial showed that Dipeptidyl Peptidase IV inhibitors (DPP-IVi) may potentially reduce the risk of DPN, while GLP-1RA did not prove to alter the measures of CAN and DPN. However, the SUSTAIN 6 trial revealed that Semaglutide may increase the risk of DR.</p><p><strong>Conclusion: </strong>Besides their anti-hyperglycemic properties, some currently reviewed medications may exhibit unique anti-microvascular abilities. Due to ambiguous and conflicting available results, more emerging or ongoing trials will address this issue and could benefit clinical strategies for personalized treatment practices.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"179"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12265122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of medication adherence and glycemic control with pain severity among patients with diabetes mellitus: a cross-sectional study from Palestine.","authors":"Bushra Elayyan, Dania Abuhalima, Samah W Al-Jabi, Sa'ed H Zyoud","doi":"10.1186/s12902-025-02000-4","DOIUrl":"https://doi.org/10.1186/s12902-025-02000-4","url":null,"abstract":"","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"180"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem cell-derived pancreatic beta cells: a step closer to functional diabetes treatment?","authors":"Ikponmwosa Jude Ogieuhi, Chinonyelum Emmanuel Agbo, Victor Oluwatomiwa Ajekiigbe, Chidera Stanley Anthony, Jennifer Chinaecherem Onyehalu, Chinemelum Kingsley Nwankwo, Mercy Chisom Agu, Kaleb Lema, Olajumoke Adesola Adewole, Oluwatobi Asade, Simbiat Quadri Eniola, Ogochuku Elizabeth Obiaghanwa, Sheeba Abraham Jeyaraj, Ifeoluwa Sandra Bakare","doi":"10.1186/s12902-025-01997-y","DOIUrl":"https://doi.org/10.1186/s12902-025-01997-y","url":null,"abstract":"","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"181"},"PeriodicalIF":2.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors and outcomes of thyroid immune-related adverse events following PD-1/PD-L1 inhibitors treatment in a large tertiary Chinese center.","authors":"Wenwen Gong, Erhan Zheng, Minchao Liu, Yaliang Han, Zhaohui Lyu, Qinghua Guo","doi":"10.1186/s12902-025-01986-1","DOIUrl":"10.1186/s12902-025-01986-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics, related risk factors and outcomes of thyroid immune-related adverse events (irAEs) in patients with malignant solid tumor treated with programmed cell death-1 (PD-1) or programmed cell death-ligand 1 (PD-L1) inhibitors in a large tertiary Chinese center.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical data of 1151 patients with malignant solid tumors who received PD-1 or PD-L1 inhibitors treatment and underwent thyroid function evaluation in a large 3 A hospital of Beijing from September 2019 to December 2023. According to the thyroid status after receiving PD-1/PD-L1 inhibitors treatment, patients were divided into normal thyroid group and thyroid irAEs group. The clinical characteristics, including age, gender, tumor type, previous anti-cancer treatment history and thyroid function status were evaluated. After the occurrence of thyroid irAEs, thyroid function evaluation, onset time, and survival outcomes were analyzed. Risk factors that may contribute to the thyroid irAEs were further explored by logistic regression.</p><p><strong>Results: </strong>Out of 1151 patients treated with a PD-1/PD-L1 inhibitor, 257 (22.3%) developed new thyroid irAEs, with the vast majority (98.0%) being hypothyroidism (193/257, 75.1%) and Grade1-2 (252/257, 98.0%), including 252 Hashimoto's thyroiditis (98.0%), 3 subacute thyroiditis (1.17%) and 2 Graves' disease (0.78%). There was a significant difference in the number of treatment cycles of PD-1/PD-L1 inhibitors between the two groups (P = 0.001). In multivariate analysis, gastrointestinal cancer, radiotherapy history, targeted therapy history, positive TgAb and TPOAb at baseline were associated with thyroid irAEs caused by PD-1/PD-L1 inhibitors. Absence of thyroid irAEs predicted increased mortality overall (HR = 2.935, P = 0.024) and particularly in gastrointestinal cancers (HR = 9.453, P = 0.007), despite comparable crude mortality (5.84% vs. 5.82%, P = 0.228). No association was observed in lung/other tumors. Thyroid function recovery occurred in 36.2% of patients, and treatment interruption due to thyroid irAEs was rare (3.5%).</p><p><strong>Conclusion: </strong>In our group, 22.3% patients treated with PD-1/PD-L1 inhibitors developed thyroid irAEs. The main subtype of thyroid irAEs was hypothyroidism (75.1%). Patients with gastrointestinal cancer, previous radiotherapy, history of targeted therapy, and baseline TgAb or TPOAb positivity may increase the risk of thyroid irAEs. Thyroid irAEs was associated with a trend for a survival benefit in patients with gastrointestinal cancer.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"171"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behavioral and demographic associations of optimal glycemic control among patients with type 2 diabetes mellitus in Sri Lanka: a multicenter study.","authors":"Warsha De Zoysa, Thilak Priyantha Weerarathna, Ipitagama Liyana Arachchige Nuwan Darshana, Udari Kaushalya Egodage, Priyamali Jayasekara, Vathulan Sujanitha, Shehan Silva, Chamila Mettananda, Manoji Pathirage, Udayangani Ramadasa, Dhammika Randula Palangasinghe, Keddagoda Gamage Piyumi Wasana, Sahan Mendis","doi":"10.1186/s12902-025-01994-1","DOIUrl":"10.1186/s12902-025-01994-1","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is an escalating global public health concern. Effective management of T2DM needs a holistic approach, considering not only the medical interventions but also demographic and behavioral factors. This multicenter study aims to investigate the association between optimal glycemic control and demographic and behavioral factors among patients with T2DM followed up in outpatient clinics of tertiary care hospitals across Sri Lanka.</p><p><strong>Methods: </strong>A cross-sectional study was carried out involving T2DM patients (n = 2013) visiting outpatient clinics at seven tertiary care facilities across five provinces in Sri Lanka. Information related to sociodemographic and behavioral factors was collected using an interviewer-administered questionnaire. HbA_1C < 7% was considered as optimal glycemic control. Predictors for glycemic control were identified using multiple logistic regression at a 0.05 significance level.</p><p><strong>Results: </strong>Out of the total sample, 99.1% were on pharmacological treatment for T2DM while the minority were solely on dietary management. The optimal glycemic control had been achieved by 43.4%. Female gender (aOR = 1.56, 95% CI 1.18-2.05), younger age group (aOR = 1.39, 95% CI 1.06-1.82), non-Sinhalese ethnicities (aOR = 1.34, 95% CI 1.02-1.77), inadequate adherence to antidiabetic medication (aOR = 1.71, 95% CI 1.31-2.24), longer disease duration (aOR = 1.51, 95% CI 1.13-2.02), being treated with insulin (aOR = 2.79, 95% CI 1.77-4.41), and daily alcohol use (aOR = 2.27, 95% CI 1.19-4.32) were identified as risk factors for inadequate glycemic control in multiple logistic regression.</p><p><strong>Conclusion: </strong>Over 50% of individuals demonstrated suboptimal glycemic control. It is recommended to implement targeted interventions for specific subgroups to address distinct demographic and behavioral factors to achieve optimal glycemic control and clinical outcomes for diabetes patients in Sri Lanka.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"178"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-linear association between metabolic score for insulin resistance and nonalcoholic fatty liver disease: analysis of US National health and nutrition examination survey data, 2017-2020.","authors":"Shanshan Wang, Ping Li, Zhenhong Guo, Xiaojuan Rao","doi":"10.1186/s12902-025-01988-z","DOIUrl":"10.1186/s12902-025-01988-z","url":null,"abstract":"<p><strong>Background: </strong>Although the metabolic score for insulin resistance (METS-IR) is significantly associated with metabolic disorders, its dose-response relationship with nonalcoholic fatty liver disease (NAFLD) remains inconclusive. This study aimed to investigate the dose-response relationship between the metabolic score for insulin resistance and NAFLD, and to identify its inflection point.</p><p><strong>Methods: </strong>This cross-sectional study evaluated the association between METS-IR and NAFLD using multivariable logistic regression applied to data from the 2017-2020 US National Health and Nutrition Examination Survey. Non-linear dynamics were investigated through smoothing spline models and segmented regression. Subgroup comparisons were performed, and diagnostic accuracy was assessed using interaction tests and receiver operating characteristic (ROC) analysis.</p><p><strong>Results: </strong>Among 2,486 eligible participants, 804 (32.34%) were diagnosed with NAFLD. Adjusted regression models revealed a 7% increase in NAFLD likelihood per unit rise in METS-IR (odds ratio [OR] = 1.07, 95% confidence interval [CI]: 1.04-1.10; P < 0.001). Non-linear modeling identified a saturation effect with an inflection point at 46.73 units. Subgroup stratification demonstrated consistent associations across demographic categories (P > 0.05). The diagnostic performance analysis yielded an area under the curve value of 0.861 in the fully adjusted models.</p><p><strong>Conclusions: </strong>The results of this study confirmed a non-linear dose-response association between METS-IR and NAFLD. Determining the METS-IR may enhance the identification of early-stage NAFLD in clinical and public health settings.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"172"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes is associated with a poor prognosis in patients with psoriasis and coronary artery disease.","authors":"Lin Zhao, Lin Sun, KunQi Yang, ZengLei Zhang, ZuoZhi Li, Man Wang, XianLiang Zhou, Yan Zeng, WeiXian Yang","doi":"10.1186/s12902-025-01996-z","DOIUrl":"10.1186/s12902-025-01996-z","url":null,"abstract":"<p><strong>Background: </strong>There is an increased risk of diabetes and cardiovascular disease among patients with psoriasis. However, whether diabetes affects the cardiovascular adverse events in patients with psoriasis who have suffered from coronary artery disease remains unclear. This study aimed to explore the prognostic role of diabetes in this particular population.</p><p><strong>Methods: </strong>This single-center, retrospective cohort study included all consecutive adult patients with psoriasis and coronary artery disease admitted at our hospital between January 2017 and May 2022. Clinical records were collected and compared between patients with and without diabetes. Survival curves were derived using Kaplan-Meier methods. Multivariable Cox regression was used to control potential confounding.</p><p><strong>Results: </strong>This study included 305 participants, including 147 patients (48.2%) with diabetes. Patients with diabetes were more likely to have hypertension (p = 0.045), peripheral vascular disease (p = 0.043) and the history of stroke (p = 0.041). Patients with diabetes also had higher levels of low-density lipoprotein cholesterol (p = 0.039) and homocysteine (p = 0.006). After a median follow-up of 36 months, patients with diabetes had a higher incidence of major adverse cardiovascular events (MACE) than patients without diabetes (p = 0.032). According to the results of the Cox regression analysis, only diabetes (p = 0.039) was associated with MACE. The subgroup analysis showed that diabetes was associated with MACE, especially in male patients (p = 0.008) and those without chronic kidney disease (p = 0.021).</p><p><strong>Conclusion: </strong>In patients with psoriasis and coronary artery disease, diabetes is independently linked with MACE. These findings will help the risk assessment for patients with psoriasis and coronary artery disease.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"174"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between level of serum VIT D and insulin resistance in patients with MAFLD.","authors":"Alshymaa A Hassnine, Amr M Elsayed, Samar K Abdelaziez, Mahmoud M Higazi, Nagwa I Okaily, Wael Soliman","doi":"10.1186/s12902-024-01820-0","DOIUrl":"10.1186/s12902-024-01820-0","url":null,"abstract":"<p><strong>Background: </strong>Non-alcoholic fatty liver disease has been recognized as the most common metabolic liver disease in Western countries, and its prevalence is increasing all over the world. Metabolic syndrome and diabetes mellitus (DM) are closely linked to non-alcoholic fatty liver disease. Because of the close relationship between fatty liver and metabolic illnesses, NAFLD has lately been renamed as Metabolic Associated Fatty Liver Disease. HOMA-IR is thought to be the best indicator of the progression of fatty liver to advanced cirrhosis and fibrosis.</p><p><strong>Aim: </strong>to assess the relation between level of serum VIT D and insulin resistance in patients with MAFLD.</p><p><strong>Patients & methods: </strong>This cross sectional observational study included 120 subjects (60 control & 60 MAFLD patients), where clinical examination including anthropometric measurements, laboratory tests (CBC, liver and renal function, metabolic profile, serum VIT D, HOMA-IR), ultrasonography and shear wave elastography were performed on all the subjects.</p><p><strong>Results: </strong>In MAFLD patients, serum vitamin D levels were statistically significant lower (55%) than in the non-MAFLD group (15%), and they also significantly decreased as steatosis and fibrosis grades increased (P < 0.001). In addition, there is an inverse correlation between serum vitamin D levels and IR in MAFLD patients, but it is not statistically significant.</p><p><strong>Conclusion: </strong>Vitamin D supplementation may be helpful in the treatment of MAFLD since people with the condition have lower serum vitamin D levels than those without it, and these levels drastically decreased with increasing grades of fatty liver.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"176"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Apparent diffusion coefficient: a predictor of the efficacy of glucocorticoid therapy in active moderate-severe thyroid eye disease: a retrospective cohort study.","authors":"Mingqiao Zhang, Xiaohui Zhang, Qian Huang, Liang Liang, Jian Long","doi":"10.1186/s12902-025-01981-6","DOIUrl":"10.1186/s12902-025-01981-6","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the association between the apparent diffusion coefficient (ADC) of extraocular muscles (EOMs) and the efficacy of glucocorticoid (GC) therapy in patients with active and moderate-severe thyroid eye disease (TED).</p><p><strong>Method: </strong>Eighteen active and moderate-to-severe bilateral TED patients (responsive group, n = 8 patients (16 eyes); unresponsive group, n = 10 patients (20 eyes)) who underwent orbital long variable echo‑trains (Resolve)-diffusion tensor imaging (DTI) before GC therapy were retrospectively enrolled. The ADC values of each EOM were collected. The correlation between the ADC of EOMs and the efficacy of GC therapy was analyzed.</p><p><strong>Results: </strong>Age was significantly younger in the responsive group compared with the unresponsive group (52.13 ± 5.18 years vs. 58.80 ± 9.33 years, P value = 0.02).There were no statistical differences in sex, smoking, TED duration, visual acuity, intraocular pressure, exophthalmos, clinical activity score, the levels of free triiodothyronine, free tetraiodothyronine thyroid-stimulating hormone, and thyroid-stimulating hormone receptor antibody between the responsive group and the unresponsive group. Apparent diffusion coefficient in the responsive group were significantly lower than that in the unresponsive group in superior rectus muscle (1351.17 ± 232.12 vs. 1624.36 ± 193.70, P value = 0.001) and medial rectus muscle (1420.69 ± 192.05 vs. 1697.00 ± 199.89, P value = 0.001). After age, sex and CAS adjustment, ADC of the superior rectus muscle and medial rectus muscle were independent predictors of the response to GC treatment by binary logistic regression analysis. The cut-off value of ADC was 1582.00 × 10^- 3 mm²/s in superior rectus muscle with a sensitivity of 88% and a specificity of 65% respectively [ area under the curve (AUC) = 0.81]. The cut-off value of ADC was 1541.39 × 10^- 3 mm²/s in medial rectus muscle with a sensitivity of 75% and a specificity of 80% (AUC = 0.84). There were no significant difference in the predictive efficacy between the two ADC cut-off values.</p><p><strong>Conclusions: </strong>Apparent diffusion coefficient values of EOMs from resolve DTI can be used as an indicator to predict the efficacy of GC therapy. Moderate-to-severe active TED patients with low ADC values at baseline in superior rectus muscle or medial rectus muscle may respond well to GC therapy.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"177"},"PeriodicalIF":2.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12257831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}