BMC Endocrine Disorders最新文献

{"title":"Levothyroxine dose requirements, oral bioavailability and gut microbiome enterotype dynamics during the early post-bariatric period: a single-centre, prospective, cohort study.","authors":"Amr Ali Mohamed Abdelgawwad El-Sehrawy, Mohammed Ali Gameil, Ahmed Mohamed El Nakib, Abdullah A Aseeri, Mansuor A Alanazi, Saud S Alharbi, Ahmed Taki-Eldin, Marwah Suliman Maashi, Gehad Mohsen ELmazny, Husam Almansour, Rufaida Abdalla, Ismail Kandil","doi":"10.1186/s12902-026-02599-y","DOIUrl":"https://doi.org/10.1186/s12902-026-02599-y","url":null,"abstract":"<p><strong>Background: </strong>Bariatric surgery induces profound metabolic changes; however, its impact on levothyroxine (LT4) requirements, hormone pharmacokinetics, and gut microbiome composition remains incompletely understood. The current study is aimed to evaluate longitudinal changes in metabolic parameters, LT4 dose requirements, free thyroxin (FT4) absorption (AUC₀-₆h), and gut microbiome features following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).</p><p><strong>Methods: </strong>In this prospective cohort study, 79 patients with hypothyroidism undergoing bariatric surgery (RYGB n = 40; SG n = 39) were followed at baseline, 3 month, and 6 months postoperatively. Metabolic parameters, thyroid function, LT4 dose, FT4 AUC₀-₆h, and gut microbiome diversity were assessed using linear mixed-effects models.</p><p><strong>Results: </strong>Both groups showed significant metabolic improvement at 6 months, including reductions in body mass index (RYGB: 44.5 → 32.1 kg/m²; SG: 42.9 → 33.0 kg/m², p < 0.001) and fasting blood sugar (RYGB: 114.8 → 92.4 mg/dL; SG: 109.9 → 96.1 mg/dL, p < 0.001). LT4 requirements increased significantly, particularly in RYGB (137.5 → 158.2 µg/day; p = 0.018) and SG (133.3 → 144.8 µg/day; p = 0.067), with a stronger effect in weight-adjusted dose (both p < 0.05). FT4 AUC₀-₆h increased significantly after surgery (RYGB: +330 ± 210, p = 0.003; SG: +185 ± 190, p = 0.041), indicating altered LT4 pharmacokinetics. Gut microbiome analysis revealed increased Shannon diversity (RYGB p-trend = 0.048) and significant enrichment of Akkermansia muciniphila (1.20% → 2.40%, p < 0.001), particularly in RYGB. After false discovery rate (FDR) adjustment, the major longitudinal changes remained significant, particularly for metabolic parameters, LT4 dose (µg/kg/day), and Akkermansia muciniphila in the RYGB group. Patient-level analyses showed a modest positive association between changes in A. muciniphila abundance and FT4 AUC₀-₆h after multivariable adjustment, whereas other microbiome-LT4 associations were not significant.</p><p><strong>Conclusion: </strong>Bariatric surgery was associated with substantial metabolic improvement, increased LT4 requirements, increased systemic FT4 exposure, and changes in gut microbiome composition. The observed microbiome-LT4 association was modest and should be considered exploratory and hypothesis-generating rather than causal. These findings highlight the need for individualized thyroid function monitoring and LT4 dose adjustment during the postoperative period.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179499","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":"Serum melatonin levels and their relationship with inflammation and oxidative stress in patients with diabetic nephropathy: a cross-sectional case-control study.","authors":"Emel Tatlı, Tuğba Kip","doi":"10.1186/s12902-026-02634-y","DOIUrl":"10.1186/s12902-026-02634-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN), a major microvascular complication of type 2 diabetes mellitus (T2DM), is driven by oxidative stress and chronic inflammation. Melatonin, an endogenous indoleamine with potent antioxidant and anti-inflammatory properties, has been implicated in diabetic complications but its relationship with systemic inflammation and oxidative balance in DN remains incompletely characterised. This study aimed to evaluate serum melatonin levels in T2DM patients with and without nephropathy compared with healthy controls, and to assess associations with inflammatory indices (C-reactive protein, CRP; neutrophil-to-lymphocyte ratio, NLR) and total antioxidant/oxidant status (total antioxidant status, TAS; total oxidant status, TOS).</p><p><strong>Methods: </strong>This cross-sectional case-control study included 83 participants: 59 patients with T2DM (29 with DN and 30 without DN) and 24 healthy controls. Serum melatonin was measured by a validated enzyme-linked immunosorbent assay (ELISA). TAS and TOS were measured by an automated colorimetric method (Erel method). Inflammatory indices and renal-function markers were measured by standard methods. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to evaluate predictive performance for DN.</p><p><strong>Results: </strong>Serum melatonin was significantly lower in T2DM patients than controls (22.00 ± 15.56 vs. 42.88 ± 29.61 ng/L, p < 0.001), accompanied by reduced TAS (4.05 ± 3.94 vs. 7.87 ± 6.68 mmol/L, p < 0.001) and TOS (2.33 ± 2.43 vs. 8.50 ± 11.77 µmol/L, p = 0.002), and markedly elevated CRP (p < 0.001). Within the diabetic cohort, neither TAS nor TOS differed significantly between DN and non-DN patients; serum melatonin was paradoxically marginally higher in the DN group (p = 0.043), in the opposite direction to the conventionally hypothesised pattern. In contrast, DN patients had markedly higher urea and creatinine, lower albumin, and higher CRP (p = 0.008). Melatonin correlated strongly and positively with TAS (ρ = 0.83) and TOS (ρ = 0.75). Urea provided the strongest discrimination for DN among the markers assessed (area under the curve, AUC, 0.805, 95% confidence interval, CI, 0.696-0.897), followed by estimated glomerular filtration rate (eGFR) (AUC 0.737); melatonin discriminated DN only modestly (AUC 0.666).</p><p><strong>Conclusions: </strong>Serum melatonin and total antioxidant capacity are concurrently reduced in T2DM, reflecting a coupled deficit of antioxidant defence. However, melatonin and TAS/TOS did not independently distinguish DN from non-DN diabetic patients; conventional renal-function markers and CRP were the dominant correlates of nephropathy. Melatonin appears to mark the global oxidative-metabolic burden of T2DM rather than nephropathy specifically.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149134567","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":"Occupational cadmium exposure and endocrine biomarker alterations in male workers: a cross-sectional study.","authors":"Deniz Özkan Vardar, Lütfiye Tutkun, Servet Birgin İritaş, Melih Gaffar Gözükara, Gülsüm Abuşoğlu, Serdar Deniz, Vugar Ali Türksoy, Engin Tutkun","doi":"10.1186/s12902-026-02605-3","DOIUrl":"https://doi.org/10.1186/s12902-026-02605-3","url":null,"abstract":"<p><strong>Background: </strong>Occupational exposure to cadmium (Cd) remains an important environmental health concern, particularly in industrial settings where long-term exposure may affect multiple physiological systems. Although Cd has been linked to reproductive and cardiovascular toxicity, human studies that simultaneously evaluate biomarkers of endocrine and endothelial dysfunction remain limited. This cross-sectional study examined the association between occupational Cd exposure and hormonal and endothelial biomarkers in adult male workers.</p><p><strong>Methods: </strong>This cross-sectional study included 170 men, comprising 85 cadmium-exposed workers and 85 unexposed controls. Urinary cadmium concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Serum levels of total testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), arginine, and citrulline were measured using standard laboratory methods. Group comparisons and correlation analyses were conducted to assess associations between cadmium exposure and biomarker profiles.</p><p><strong>Results: </strong>Cadmium-exposed workers had substantially higher urinary Cd concentrations than controls and higher ADMA and SDMA levels (both p < 0.001). In contrast, total testosterone, FSH, and the arginine/ADMA ratio were significantly lower in the exposed group, while LH showed a smaller but statistically significant reduction. Urinary Cd was inversely correlated with total testosterone and FSH, indicating that a higher internal cadmium burden was associated with less favorable endocrine biomarker profiles.</p><p><strong>Conclusions: </strong>Occupational cadmium exposure was associated with concurrent changes in endocrine and endothelial biomarkers among male workers. These findings suggest that combined assessment of endocrine and endothelial biomarkers may be useful for occupational monitoring of workers with chronic cadmium exposure.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104007","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":"Hair cortisol as a complementary marker of chronic glucocorticoid exposure in mild autonomous cortisol secretion.","authors":"Merve Korkmaz Yilmaz, Semih Tek, Aslihan Pekmezci, Mutlu Niyazoglu, Esra Hatipoglu","doi":"10.1186/s12902-026-02607-1","DOIUrl":"10.1186/s12902-026-02607-1","url":null,"abstract":"<p><strong>Background: </strong>Mild autonomous cortisol secretion is a subtle yet clinically relevant form of cortisol excess linked to increased cardiometabolic risk. Conventional biochemical tests capture short-term hypothalamic-pituitary-adrenal axis activity and may not reflect cumulative exposure. Hair cortisol concentration has been proposed as a long-term biomarker, but evidence in mild autonomous cortisol secretion is limited.</p><p><strong>Objective: </strong>To compare hair cortisol concentration between patients with mild autonomous cortisol secretion and healthy controls, assess diagnostic performance, and examine associations with hormonal and metabolic parameters.</p><p><strong>Methods: </strong>In this cross-sectional study, 73 patients with mild autonomous cortisol secretion and 60 rigorously screened controls were included. Mild autonomous cortisol secretion was defined according to European Society of Endocrinology guidelines. Hair cortisol concentration was measured from the proximal 3-cm hair segment. Assessments included the 1-mg overnight dexamethasone suppression test, 2-day 2 mg dexamethasone suppression test, 24-hour urinary free cortisol, and late-night salivary cortisol. Correlation and receiver operating characteristic analyses were performed.</p><p><strong>Results: </strong>Hair cortisol concentration was significantly higher in patients with mild autonomous cortisol secretion than in controls (median 3.6 vs. 1.75 ng/g; p < 0.01). In patients with mild autonomous cortisol secretion, hair cortisol concentration correlated with waist circumference (ρ = 0.27; p = 0.02) and late-night salivary cortisol (ρ = 0.25; p = 0.03), but not with dexamethasone suppression test-based measures or urinary cortisol. Receiver operating characteristic analysis showed modest discrimination (AUC = 0.60, 95% CI 0.51-0.70, p = 0.025); the 2.7-ng/g cut-off yielded limited sensitivity and specificity. In multivariable logistic regression adjusted for age, sex, and body mass index, hair cortisol concentration was not independently associated with mild autonomous cortisol secretion.</p><p><strong>Conclusions: </strong>Hair cortisol concentrations were higher in patients with mild autonomous cortisol secretion than in healthy controls, suggesting that hair cortisol concentration may capture some aspects of chronic glucocorticoid exposure in this population. However, its diagnostic performance was modest, and hair cortisol concentration was not independently associated with mild autonomous cortisol secretion after adjustment for age, sex, and body mass index. Therefore, hair cortisol concentration should be regarded as a complementary rather than a standalone biomarker, and further prospective studies are needed to clarify its clinical utility.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223440","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":"Serum long noncoding RNA human plasmacytoma variant translocation 1 (PVT1) expression levels in Egyptians type 2 diabetic patients and its correlation with severity of diabetic nephropathy.","authors":"Aya Tarabay, Olfat Gamil Shaker, Naglaa M ElSayed, Dina Allam, Abeer Abdellatef, Mazen Attia","doi":"10.1186/s12902-026-02449-x","DOIUrl":"10.1186/s12902-026-02449-x","url":null,"abstract":"<p><strong>Background: </strong>Continuous rise in the global incidence of type 2 diabetes mellitus (T2DM) has been associated with a marked increase in diabetic kidney disease (DKD). Despite that, the clinical markers that are currently used for diagnosing diabetic nephropathy (DN) still not reliable. In recent years, long non-coding RNAs (lncRNAs) have drawn growing attention, with accumulating evidence linking their dysregulated expression to the onset and progression of DKD.</p><p><strong>Aim of the study: </strong>This study aimed to assess serum lncRNA PVT1 expression in Egyptian patients with type 2 diabetes mellitus and evaluate its association with the progression and severity of diabetic kidney disease.</p><p><strong>Patients and methods: </strong>A total of 80 adults were enrolled and divided into four groups (20 each): three type 2 diabetes mellitus groups stratified by urinary albumin-to-creatinine ratio (UACR; normal, moderately increased, and severely increased) and one healthy control group. Diabetic patients were further classified by fundus examination into those with and without retinopathy. All participants underwent clinical and laboratory evaluation, and serum lncRNA PVT1 expression was quantified using real-time PCR.</p><p><strong>Results: </strong>Serum lncRNA PVT1 expression was markedly elevated in patients with type 2 diabetes compared to healthy controls, with significantly higher levels observed in G3 relative to G1. A significant positive correlation was found between PVT1 expression and UACR, serum creatinine, age, BMI, fasting blood glucose, 2-hour postprandial glucose, and HbA1c. Conversely, PVT1 demonstrated a significant negative correlation with eGFR, ALT, and platelet count. Notably, PVT1 emerged as the sole independent predictor of proteinuria among diabetic patients.</p><p><strong>Conclusion: </strong>lncRNA PVT1 is significantly overexpressed in T2DM patients and correlates with glycemic status and renal dysfunction. It serves as a potential reliable biomarker for DKD severity and progression and represents a potential therapeutic target.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587462/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149001264","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":"Immunohistochemical evaluation of apelin and VEGF expression in cortisol-producing adrenal adenomas.","authors":"Hatice Çalişkan Burgucu, Tuğba Günler, Ethem Ömeroğlu, Yaşar Ünlü, Oğuzhan Aksu","doi":"10.1186/s12902-026-02563-w","DOIUrl":"10.1186/s12902-026-02563-w","url":null,"abstract":"<p><strong>Purpose: </strong>In this study, we aimed to investigate the immunohistochemical expression of apelin in tissue samples obtained from patients with Cushing's syndrome (CS) due to cortisol-producing adrenal adenoma (CPA) and to compare these findings with normal adrenal cortex tissue. Additionally, we sought to evaluate the association of apelin expression with clinical, hormonal, and histopathological parameters. The expression profile of vascular endothelial growth factor (VEGF) was also assessed to explore potential angiogenic interactions.</p><p><strong>Methods: </strong>This retrospective, single-center study included 11 patients diagnosed with CPA and 15 control subjects with histologically normal adrenal cortex tissue. Formalin-fixed, paraffin-embedded tissue sections were subjected to immunohistochemical staining for apelin and VEGF. Immunohistochemical evaluation was performed by assessing staining intensity and the percentage of positively stained cells. An immunoreactivity score (IRS) was calculated by combining these parameters to provide a semi-quantitative measure of protein expression.</p><p><strong>Results: </strong>Apelin staining intensity was significantly higher in CPA tissues compared with controls (p = 0.026), whereas the percentage of apelin-positive cells and IRS values did not differ significantly between groups. In an exploratory ROC analysis, apelin staining intensity showed moderate discrimination between CPA and control adrenal cortex tissues (AUC = 0.776, 95% CI: 0.581-0.971, p = 0.018). In bias-reduced univariable logistic regression, apelin staining intensity was associated with CPA (OR = 2.96, 95% CI: 1.02-8.60, p = 0.046), although the wide confidence interval indicated considerable uncertainty. VEGF staining parameters did not differ significantly between CPA and control tissues. No statistically significant correlations could be demonstrated between apelin or VEGF IRS and the evaluated clinicopathological or hormonal parameters.</p><p><strong>Conclusion: </strong>Apelin staining intensity was higher in CPA than in normal adrenal cortex, whereas the proportion of apelin-positive cells and IRS did not differ significantly between groups. VEGF staining parameters also did not differ significantly between CPA and control tissues. These findings suggest altered apelin immunoreactivity in CPA; however, given the exploratory nature and small sample size of the study, larger studies are required to confirm these observations and clarify their biological significance.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982267","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":"Efficacy and safety of orforglipron 12 mg versus orforglipron 36 mg maintenance dose among patients with obesity with or without diabetes: a systematic review and comprehensive meta-analysis.","authors":"Mohamed Gamal Hegaz, Mohammad Yassin Al Aboud, Abanoub I I Kamel, Muhammad Abdullah Naveed, Omar Gamal Elsayed, Aqsa Zoey Sorathia","doi":"10.1186/s12902-026-02538-x","DOIUrl":"10.1186/s12902-026-02538-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity is projected to affect about one billion adults by 2030 and is associated with cardiometabolic morbidity. Orforglipron is an oral, non-peptide glucagon-like peptide-1 receptor agonist developed to provide weight and metabolic benefits. Prior meta-analyses have supported its efficacy and safety but were limited by shorter follow-up and a predominance of non-diabetic populations. This meta-analysis aims to provide the most comprehensive head-to-head comparison between the two most commonly studied maintenance doses (12 mg vs. 36 mg), assessing weight, glycemic, cardiometabolic, and safety outcomes.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Cochrane, and Scopus until March 1, 2026, for randomized controlled trials (RCTs) comparing orforglipron 12 mg and 36 mg in obese adults. Outcomes of interest included percentage and absolute body weight change, BMI, HbA1c, waist circumference, lipid parameters, blood pressure, and adverse events. Results were pooled using a fixed-effects model, and prespecified subgroup analyses examined differences by diabetes status and treatment duration.</p><p><strong>Results: </strong>Six RCTs (3459 participants) were included. Compared with the 12 mg dose, the 36 mg dose was associated with greater reductions in percentage body weight change (p < 0.00001), absolute body weight change (p < 0.00001), body mass index (p < 0.00001), HbA1c (p < 0.00001), waist circumference (P < 0.00001), percent change in triglycerides (P = 0.002), and systolic blood pressure (P = 0.002). Adverse events were comparable between doses. No significant differences were observed in gastrointestinal events or pancreatic functions. A small difference in pulse rate was noted but was not considered clinically significant.</p><p><strong>Conclusion: </strong>In obese adults, orforglipron 36 mg improved weight and metabolic outcomes compared with 12 mg. No statistically significant differences between doses were detected for the prespecified safety outcomes, although small increases in ALT and AST were observed with the 36 mg dose and the trials included were not powered to detect rare or long-term adverse events. These findings support consideration of the higher maintenance dose when clinically appropriate. Longer-term studies are needed to confirm the benefit and cardiovascular outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13579720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982284","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":"Effects of SGLT-2 inhibitors on thyroid-stimulating hormone and systemic immune-inflammation index in type 2 diabetes: a retrospective study.","authors":"Seyit Murat Bayram, Hüseyin Demirci, Enes Üçgül, Şule Canlar, Murat Cinel, Burak Menekşe, İlknur Alkan Kuşabbi, Erman Çakal","doi":"10.1186/s12902-026-02483-9","DOIUrl":"10.1186/s12902-026-02483-9","url":null,"abstract":"<p><strong>Background/aim: </strong>This retrospective study examined whether long-term SGLT-2i use is associated with differences in thyroid-stimulating hormone (TSH) and the systemic immune-inflammation index (SII) in patients with type 2 diabetes mellitus (T2DM) without known thyroid disease. The neutrophil-to-lymphocyte ratio (NLR), renal function (eGFR), diabetes duration, and metformin use were also evaluated as potential covariates.</p><p><strong>Methods: </strong>This was a single-center, retrospective observational study. Adults with T2DM who had used empagliflozin or dapagliflozin for at least six months were compared with an age- and sex-matched control group of patients with T2DM not using SGLT-2i, drawn from the same outpatient clinics. Key exclusion criteria included known thyroid disease, known positivity for thyroid autoantibodies, active inflammatory or autoimmune processes, advanced organ failure, and immunomodulatory treatment. TSH, SII, and NLR were measured. Statistical analyses included intergroup comparisons, correlation, multivariate linear regression, post-hoc power calculation, and multicollinearity diagnostics (variance inflation factor, VIF).</p><p><strong>Results: </strong>The study included 330 patients across the empagliflozin (n = 139), dapagliflozin (n = 85), and control (n = 106) groups. Median TSH (1.6, 1.8, and 1.9 µIU/mL; p = 0.338) and SII (481, 531, and 468.5; p = 0.509) did not differ significantly between groups. SII and NLR were significantly correlated (r = 0.467, p < 0.001). In multivariate regression, female sex (B = 0.161, p = 0.015) and eGFR (B=-0.0043, p = 0.037) were independent predictors of log-transformed TSH; SGLT-2i use, SII, NLR, age, metformin use, and diabetes duration were not. The study had 80% power to detect a Cohen's f of 0.17 or greater; observed effect sizes were substantially below this threshold (f = 0.02 for TSH, f ≈ 0.00 for SII).</p><p><strong>Conclusion: </strong>Long-term SGLT-2i use was not associated with significant changes in TSH or SII in patients with T2DM without known thyroid disease, and the achieved effect sizes suggest that any true effect, if present, is likely small. Renal function emerged as an independent correlate of TSH, suggesting that the relationship between the hypothalamic-pituitary-thyroid axis and renal physiology merits further attention in this population, independent of SGLT-2i exposure. Prospective, multicenter studies incorporating free thyroxine and triiodothyronine measurements are warranted to further clarify these relationships.</p><p><strong>Clinical trial number: </strong>This study is retrospective and does not involve a clinical trial registration.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191282","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":"Metabolic and hormonal correlates of leptin, uric acid and soluble neprilysin in polycystic ovary syndrome/ Polyendocrine Metabolic Ovarian Syndrome.","authors":"Bayram Burak Ceviz, Ozgur Baykan, Figen Efe Camili, Selim Afsar, Mine Islimye Taskin, Orkun Cetin","doi":"10.1186/s12902-026-02507-4","DOIUrl":"10.1186/s12902-026-02507-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Polycystic ovary syndrome (PCOS) / Polyendocrine Metabolic Ovarian Syndrome (PMOS) is a complex endocrine and metabolic disorder in women of reproductive age. This study aimed to evaluate the relationship between serum leptin, uric acid and soluble neprilysin levels and metabolic and hormonal parameters in women with PCOS/PMOS. The evaluation of new metabolic biomarkers in conjunction with hormonal parameters may contribute to a better understanding of the metabolic aspects and pathophysiology of PCOS/PMOS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This case-control study was conducted on 90 women, including 60 patients diagnosed with PCOS/PMOS and 30 healthy age-matched controls. The PCOS/PMOS group was further divided into obese and non-obese subgroups according to body mass index (BMI). Demographic characteristics, Ferriman-Gallwey (FG) scores, anthropometric measurements, hormonal profiles (anti-Müllerian hormone (AMH), thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone, progesterone, prolactin, estradiol), and metabolic parameters (fasting blood glucose, insulin, triglycerides, uric acid) were recorded. Venous blood samples were collected after an 8-12-hour fast during the early follicular phase of the menstrual cycle. Serum leptin and soluble neprilysin levels were measured using the ELISA method. Group comparisons, post-hoc analyses, correlation analysis, ROC analysis, age- and BMI-adjusted ANCOVA, and penalized LASSO logistic regression were performed to evaluate biomarker associations and discriminatory performance for PCOS/PMOS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;LH, AMH, testosterone, HOMA-IR, triglycerides, uric acid, and leptin levels were significantly higher in the PCOS/PMOS group than in controls, with the most pronounced metabolic abnormalities observed in the obese PCOS/PMOS subgroup. Leptin levels were highest in obese women with PCOS/PMOS (p &lt; 0.001), whereas soluble neprilysin levels did not differ significantly among groups (p = 0.233). Correlation analyses showed that leptin was strongly associated with adiposity and insulin-resistance-related parameters, including BMI, HOMA-IR, and uric acid. ROC analysis demonstrated strong discriminatory performance for waist-to-height ratio (AUC = 0.899), testosterone (AUC = 0.895), waist-to-hip ratio (AUC = 0.891), and AMH (AUC = 0.882), while HOMA-IR, leptin, and TyG index showed acceptable discriminatory ability. After adjustment for age and BMI, only TyG index and WHR remained significantly different among groups, whereas leptin and soluble neprilysin did not. LASSO logistic regression retained AMH, testosterone, WHR, and log-transformed leptin in a parsimonious classification model, indicating that hormonal markers and central adiposity indices contributed most consistently to PCOS/PMOS classification, while the independent contribution of leptin appeared limited by its close associati","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073483","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":"Glycated hemoglobin and bone mineral density in adults with and without type 2 diabetes: a cross-sectional DXA study from the Qassim region, Saudi Arabia.","authors":"Hajed Obaid Alharbi, Amal Hussain Mohammed, Sahar Mohammed Alatni, Layla Sharfaldeen Mohamed Ahmed, Metab Algeffari, Bassam Alkhalifah, Hamad Suliman Alsheeb, Afshan Zeeshan Wasti, Shakera Khatoon","doi":"10.1186/s12902-026-02474-w","DOIUrl":"10.1186/s12902-026-02474-w","url":null,"abstract":"<p><strong>Background: </strong>This comparative cross-sectional study evaluated bone mineral density (BMD) and its association with glycemic control and biochemical bone markers among adults with and without type 2 diabetes mellitus (T2DM) in the Qassim region, Saudi Arabia.</p><p><strong>Methods: </strong>A comparative cross-sectional study was conducted among 73 adults (comprising individuals with T2DM and non-diabetic controls) recruited from healthcare facilities in the Qassim region, Saudi Arabia. Clinical, demographic, and bone health data were collected using a structured questionnaire and hospital medical records. Glycated hemoglobin (HbA1c), serum calcium, alkaline phosphatase (ALP), fracture history, and bone mineral density were evaluated. BMD was measured at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry (DXA) and classified according to the World Health Organization (WHO) criteria. Statistical analyses were performed using SPSS version 23.0.</p><p><strong>Results: </strong>T2DM was diagnosed in 69.9% of participants; 48.0% had osteopenia and 19.2% had osteoporosis. Chronological age was associated with progressive bone mineral density loss across successive cohorts (Pearson χ² = 11.14, p = 0.025). Among participants with T2DM, mean HbA1c increased progressively with longer diabetes duration (Spearman's rho = 0.310, p = 0.027). In an exploratory multinomial logistic regression model, higher HbA1c was associated with lower bone mineral density categories each 1% increase in HbA1c was associated with higher odds of osteopenia (adjusted odds ratio [aOR] = 2.34, 95% confidence interval [CI]: 1.12-4.88; p = 0.024) and osteoporosis (aOR = 3.89, 95% CI: 1.45-10.42; p = 0.007). Serum calcium and alkaline phosphatase (ALP) were not significantly associated with bone mineral density.</p><p><strong>Conclusions: </strong>Low bone mineral density was common in this study population. Higher HbA1c levels were associated with lower bone mineral density categories in an exploratory regression model adjusted for the variables included in the analysis. These findings support further investigation of the relationship between glycaemic control and bone health in larger prospective studies with comprehensive adjustment for clinical confounders.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812052","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}