BMC Endocrine Disorders最新文献

{"title":"Unusual nodular goiter with recurrent laryngeal nerve palsy due to severe degeneration caused by intense chronic inflammation: a case report with histopathological evidence and review of the literature.","authors":"Ryo Takagi, Kosei Mori, Sayumi Tsuyuguchi, Takashi Koike, Dinh Nam Nguyen, Kengo Kanai, Yoshihiro Watanabe, Mitsuhiro Okano, Yoshihiro Noguchi, Yuichiro Hayashi, Yorihisa Imanishi","doi":"10.1186/s12902-025-01929-w","DOIUrl":"10.1186/s12902-025-01929-w","url":null,"abstract":"<p><strong>Background: </strong>Thyroid tumors presenting with recurrent laryngeal nerve (RLN) palsy are generally considered malignant; however, RLN palsy has been reported even in benign thyroid disease (BTD), mainly due to compression or stretching, although seemingly quite rare. Herein, we report an unusual case of nodular goiter that was extremely difficult to differentiate preoperatively from thyroid malignancy because of the concomitant ipsilateral RLN palsy caused by chronic inflammation.</p><p><strong>Case presentation: </strong>A 59-year-old Japanese female presented with hoarseness and pharyngeal discomfort. Endoscopic examination revealed fixation of the right vocal cord, presumably due to right RLN palsy. Ultrasonography and computed tomography showed an ill-defined thyroid mass lesion in the right lobe, strongly suggestive of malignancy, although repeated aspiration cytology revealed no suspicion of malignancy. Intraoperatively, because the right RLN was found to be entirely embedded within the hard mass lesion and completely unresponsive to nerve integrity monitoring, the nerve was unavoidably excised along with the right lobe. Histopathology led to the final diagnosis of nodular goiter, wherein the resected RLN was severely degenerated and disrupted due to intense chronic inflammation accompanied by perineural fibrosis.</p><p><strong>Conclusions: </strong>Our literature review suggests that RLN palsy associated with thyroid mass lesions should not be considered a definitive indicator of malignancy because it can also be observed in BTD, although it is significantly less frequent than in malignancy as corroborated by our meta-analysis. Even in BTD, if the primary cause of the coexisting RLN palsy is severe chronic inflammation, nerve preservation is potentially unfeasible.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"128"},"PeriodicalIF":2.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969259","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":"Application of the C-reactive protein-triglyceride glucose index in predicting the risk of new-onset diabetes in the general population aged 45 years and older: a national prospective cohort study.","authors":"Yingqi Shan, Qingyang Liu, Tianshu Gao","doi":"10.1186/s12902-025-01947-8","DOIUrl":"https://doi.org/10.1186/s12902-025-01947-8","url":null,"abstract":"<p><strong>Objective: </strong>Triglyceride-to-glucose index (TyG index) and inflammation are both independent risk factors for diabetes. However, only a few studies have combined TyG index with inflammation indices to predict diabetes risk. C-reactive protein-triglyceride-to-glucose index (CTI index), as a new type of lipid and inflammation marker, can comprehensively assess the severity of insulin resistance and inflammation. This study explores the association between CTI index and diabetes risk.</p><p><strong>Methods: </strong>We recruited a total of 6,728 participants from the China Health and Retirement Longitudinal Study (CHARLS) who had no history of diabetes at baseline. After determining the key predictors using the least absolute shrinkage and selection operator (LASSO) technique, the relationship between the CTI index and the risk of new-onset diabetes was assessed using multivariate COX regression, the mediating effect between insulin resistance and inflammatory indicators was explored, and restricted cubic splines (RCS) were applied to explore the association between the CTI index and the risk of new-onset diabetes. In addition, we used decision tree analysis to identify people at high risk of diabetes, calculated time-dependent Harrell's C index (95% CI) to assess the predictive ability of TyG, CRP, CTI and CRP + TyG for new-onset diabetes, and further calculated IDI and NRI to assess the predictive ability of CTI and TyG. Finally, we performed subgroup analyses for different subgroups using stratified COX proportional hazard regression models; and a series of sensitivity analyses were performed to verify the robustness of our results.</p><p><strong>Results: </strong>The incidence of diabetes was 15.9% during the 9-year follow-up. COX regression analysis showed that the risk ratio for diabetes increased gradually with an increase in the CTI index. The RCS curve confirmed the existence of a linear relationship between the CTI index and the risk of diabetes. Decision tree analysis showed that the CTI index was a key indicator of diabetes risk. In addition, the CTI index is a much better predictor of the onset of diabetes risk than the TyG index, as demonstrated by the integrated discrimination improvement (IDI) and net reclassification improvement (NRI).</p><p><strong>Conclusion: </strong>An increase in CTI levels is closely related to diabetes risk, and the CTI index may become a unique predictor of diabetes risk.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"126"},"PeriodicalIF":2.8,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954051","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 CDKAL1 gene polymorphisms variations with gestational diabetes mellitus risk in women: A case-control study and meta-analysis.","authors":"Watson Ray Gyan, Hengli Zhang, Taotao Shao, Taili Yang, Yue Wei, Mianqin Li, Xiaoqun Che, Qiaoli Zeng, Runmin Guo","doi":"10.1186/s12902-025-01874-8","DOIUrl":"10.1186/s12902-025-01874-8","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) has seen a significant rise and has become a growing concern worldwide, especially in Asian populations. Genetic factors, such as variations in the CDKAL1 gene, have been linked to its development. However, existing research on this connection is limited and inconclusive, highlighting the need for further investigation. This study aims to explore the association between CDKAL1 gene polymorphisms and GDM risk in a Chinese population using a comprehensive case-control study and meta-analysis.</p><p><strong>Methods: </strong>The SNPscan™ genotyping assay was used to genotype rs7754840 and rs7756992, in 502 control participants and 500 GDM patients. ANOVA, T-test, chi-square test, logistic regression, and other statistical tests were used to determine the differences in genotypes and alleles and their associations to the risk of GDM. Additionally, a meta-analysis of existing studies on CDKAL1 polymorphisms and GDM was performed to provide a broader context and resolve inconsistencies in the literature.</p><p><strong>Results: </strong>The GDM group had a significantly older average mean age and higher blood pressure, and fasting plasma glucose levels than the control group (P < 0.05). CDKAL1 rs7754840 showed significant associations under codominant homozygous model (CC vs. GG: OR = 1.748; 95% CI: 1.178-2.593; P = 0.006). After adjusting, these results indicated an association between CDKAL1 rs7754840 and increased risk of GDM in the codominant model (OR = 1.715; 95% CI: 1.133-2.595; P = 0.011). However, further analysis revealed no significant associations under all genetic models for CDKAL1 rs7756992. The study found that individuals under 30 with the rs7754840 CC genotype had higher fasting glucose and postprandial glucose levels (P < 0.05) compared to those with the GG genotype. Figure 3 A demonstrated a modest association between the CDKAL1 and GDM susceptibility (OR 1.16, 95% CI 1.104-1.29, P = 0.0258).</p><p><strong>Conclusion: </strong>Individuals with the CDKAL1 rs7754840 polymorphism was associated to an increased risk of GDM, whereas rs7756992 did not show significant association with GDM risk. These results provide a theoretical foundation for GDM testing to mitigate its associated complications by enhancing our ability to predict, prevent and manage GDM. Ultimately improving outcomes for both mothers and their children. This research contributes to the growing evidence of genetic predisposition to GDM and highlights the importance of CDKAL1 as a potential genetic marker for GDM risk assessment.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"125"},"PeriodicalIF":2.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963566","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":"Prevalence of diabetes mellitus among traumatic patients admitted to Aseer Central Hospital, Aseer Region, Abha, Saudi Arabia: cross-sectional study.","authors":"Majed Mohammed Al Saleh, Bandar A Alasmari, Ali Mohammed AlAmri, Mohammed Mabkhoot Mogbel, Ali Saeed Alasmary, Alhussein Ali Almonawar, Saeed Doos S Almontashri, Hassan Mussa Al Mojamad, Turki Abdullah Al Qahtani, Abdulrahman Mohammed Alshehri, Ibrahim Mohammed I Almoftery","doi":"10.1186/s12902-025-01949-6","DOIUrl":"https://doi.org/10.1186/s12902-025-01949-6","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries among patients with diabetes mellitus (DM) are associated with extended hospital stays and higher mortality rates.</p><p><strong>Objectives: </strong>This study aimed to estimate the prevalence of DM among traumatic patients admitted to Aseer Central Hospital, Aseer Region, Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional design was conducted among trauma casualties aged 18 years and older admitted to the Trauma Center of Asser Central Hospital, Abha, Saudi Arabia, for six months from July 1 to December 31, 2024. Data were collected using an interviewer-administered questionnaire. The questionnaire covered various aspects, including demographic information, smoking status, presence of chronic diseases, previous diabetes diagnoses, details of any accidents, diabetes diagnosis during the accident, and self-care practices.</p><p><strong>Results: </strong>Three hundred and eleven trauma casualties were included with a mean age of 46.7 ± 12.9. Of them, 60.8% were men. The study found that the prevalence of diabetes among trauma casualties was 8.7%, with 48.2% incidentally discovered during the current trauma. Among diagnosed patients, 33.3% had glycated hemoglobin (HbA1c) levels between 7.51-8.5%, 11.1% between 8.51-9.5%, and 22.2% exceeded 9.5%. The predictors of diabetes diagnosis included smoking (OR = 6.39, 95% CI = 2.08-19.63), lower levels of education levels (OR = 0.75, 95% CI = 0.58-0.96), and a positive family history (OR = 24.9, CI = 7.96-78.36).</p><p><strong>Conclusions: </strong>The study found an 8.7% prevalence of diabetes among trauma casualties, with nearly half discovered during the event. Factors like smoking, education, and family history of diabetes were associated with diagnosis. Routine diabetes screening is crucial for early detection and management. Targeted interventions, such as multidisciplinary care teams and telemedicine, can improve diabetes management. Further research is needed to address cultural and socioeconomic factors.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"122"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963570","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":"Influence of glucagon-like peptide-1 receptor agonists on renal parameters: a meta-analysis of randomized controlled trials.","authors":"Wenjing Li, Xiaoyan Liang, Na Sun, Daqing Zhang","doi":"10.1186/s12902-025-01948-7","DOIUrl":"10.1186/s12902-025-01948-7","url":null,"abstract":"<p><strong>Aims: </strong>To verify the influence of glucagon-like peptide-1 receptor agonists (GLP-1 RA) on renal function parameters in type 2 diabetes based on well-known randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>PubMed, Cochrane, Web of Science, Embase, and grey literature were searched for RCTs published until December 24, 2024. The quality of the RCTs was assessed using the Cochrane risk-of-bias tool. Weighted mean differences (WMD) and 95% confidence intervals (CIs) were calculated for continuous variables using meta-analysis. The primary outcomes were composite renal function parameters, including serum creatinine (Cr) levels, estimated glomerular filtration rate (eGFR), urinary albumin excretion (UAE), and urinary albumin-to-creatinine ratio (UACR).</p><p><strong>Results: </strong>Pooled data from 24 studies revealed that GLP-1 RA positively influenced renal outcomes in the type 2 diabetes group to some extent compared with that in the control group. GLP- 1 RA decreased serum creatinine levels (WMD=-0.10, 95%CI -0.19 to -0.01, I² = 33%, P < 0.05), eGFR(WMD = 0.54, 95% CI 0.19 to 0.90, I² = 27%, P < 0.05), UAE (WMD=-11.92, 95% CI - 23.50 to - 0.33, I² = 0%, P < 0.05) and UACR (WMD: -1.01 mg/g, 95% CI:-1.68, -0.34, I² = 15%, P < 0.05) in the type 2 diabetes group.</p><p><strong>Conclusion: </strong>GLP-1 RA treatment significantly elevated eGFR, decreased the UACR, and positively influenced renal function outcomes in the type 2 diabetes group.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"124"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969262","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":"Insular thyroid carcinoma: epidemiological pattern, factors contributing to recurrence and distant metastasis.","authors":"Omar Hamdy, Shadi Awny, Mohamed H Sous, Mohamed A Abdelfattah, Ahmed E Eladl, Amr F Elalfy","doi":"10.1186/s12902-025-01877-5","DOIUrl":"10.1186/s12902-025-01877-5","url":null,"abstract":"<p><strong>Background: </strong>Insular thyroid carcinoma is a rare subtype of thyroid cancer that constitutes an intermediate entity between differentiated (papillary & follicular) and undifferentiated (anaplastic) thyroid cancer.</p><p><strong>Methods: </strong>This is a retrospective study that included all the patients with insular carcinoma of the thyroid gland who underwent surgical treatment in our department from January 2009 to December 2023. The epidemiological, clinical, and oncological data of the included patients were analyzed.</p><p><strong>Results: </strong>A total of 1690 patients with thyroid cancer were screened. Twenty-four patients were included in the final analysis. The median time to recurrence (95% CI) was 24 months while the Restricted Mean Survival Time (RMST) at time point 24 months (95% CI) was 16.95. The median time to distant metastasis is 60 months while RMST at time point 24 months was 17.1. The median time to death was 55 months. There was a statistically significant difference in the RMST at 24 months for overall survival (OS) as regards older age, presence of comorbidity, multifocality, and lack of adjuvant RAI, but not sex. Male sex and lack of adjuvant RAI therapy were statistically significant independent predictors of the time to locoregional recurrence. There was no statistically significant difference in the time to distant metastasis as regards all the variables.</p><p><strong>Conclusions: </strong>From our results, we can conclude that male sex, multifocality, and lack of RAI affect survival in patients with insular thyroid carcinoma. Adequate surgical resection of the thyroid gland and draining lymph nodes in addition to radioactive iodine remains the mainstay of treatment.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"123"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954228","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":"Neonatal graves' disease complicated with cholestatic jaundice: a case report.","authors":"Ya-Ping Tian, Bei Luo, Hui Wang, Hong Jing, Xue-Feng Zhang","doi":"10.1186/s12902-025-01938-9","DOIUrl":"10.1186/s12902-025-01938-9","url":null,"abstract":"<p><strong>Background: </strong>Neonatal cholestatic jaundice and elevated liver enzymes can result from various etiologies, including anatomical, infectious, endocrine, and metabolic abnormalities. Unlike hypothyroidism, hyperthyroidism is rarely associated with neonatal cholestasis. This study presents a unique case of neonatal Graves' disease complicated by cholestatic jaundice and discusses the challenges in diagnosis, treatment, and management.</p><p><strong>Case presentation: </strong>We report a 30-day-old male infant, born by vaginal delivery at 36.4 weeks gestational age, born weight was 2550 g, to a mother with a history of hypothyroidism during pregnancy, undiagnosed thyroid disease before. The infant developed manifestations of hyperthyroidism, poor weight gain, and cholestatic jaundice shortly after his inception. A variety of tests were used to confirm the diagnosis of neonatal Graves' disease. After 6 weeks of propylthiouracil and hepatoprotective choleretic therapy, thyroid-thyrotropic hormonal metabolism returned to normal, cholestatic jaundice disappeared after 2 months, and liver enzymes returned to normal after 3 months. In addition, the child's weight and length growth returned to the normal range during the follow-up period.</p><p><strong>Conclusions: </strong>Neonatal Graves' disease can be associated with cholestatic jaundice and may have long-term health consequences for the newborn. Early diagnosis and appropriate treatment are crucial for improving the prognosis. This case emphasizes the importance of monitoring pregnant women for thyroid dysfunction and its potential impact on the newborn.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"121"},"PeriodicalIF":2.8,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974695","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":"Positive impact of mobile educational platforms on blood glucose control in patients with nephrotic syndrome and steroid-induced diabetes mellitus: a randomized controlled study.","authors":"Zhimin Yang, Zhicheng Tan, Minna Sun, Jing Zhang, Haizhu Hou, Xin Li","doi":"10.1186/s12902-024-01802-2","DOIUrl":"https://doi.org/10.1186/s12902-024-01802-2","url":null,"abstract":"<p><strong>Objective: </strong>Steroid-induced diabetes mellitus (SDM) is a common complication in patients with nephrotic syndrome (NS) undergoing steroid therapy. Effective blood glucose control is critical for improving outcomes in these patients. This study evaluates the impact of mobile educational platforms on blood glucose control and patient adherence in patients with NS combined with SDM.</p><p><strong>Methods: </strong>A randomised controlled study was conducted involving 56 patients with NS and SDM at Shanxi People's Hospital between April 2019 and December 2020. Participants were recruited using convenient sampling and were randomly assigned to either the intervention group (n = 28) or the control group (n = 28). The control group received routine health management, whereas the experimental group was provided with health management via a mobile educational platform. Blood glucose levels (fasting glucose and postprandial blood glucose), self-management efficacy and patient adherence to treatment were assessed over a 6-month period.</p><p><strong>Results: </strong>The 56 participants included in the study had a mean age of 69.0 ± 10.5 years and an average diabetes duration of 7.2 ± 3.5 years. At the end of 6 months, the intervention group showed significant reductions in fasting blood glucose and postprandial blood glucose levels (P < 0.001). Self-management efficacy, assessed using the Diabetes Self-Efficacy Scale, improved significantly post-intervention (4.42 ± 0.53 vs. 4.15 ± 0.56, P = 0.020). Additionally, patient adherence to treatment improved by 25% in the intervention group compared with the control group.</p><p><strong>Conclusion: </strong>The use of mobile educational platforms significantly resulted in better glycemic control and treatment adherence in the patients with NS and SDM compared to the control group. These findings suggest that integrating mobile health technologies into routine care can enhance disease management and optimise outcomes.</p><p><strong>Trial registration: </strong>The study was retrospectively registered \"ISRCTN23135945\" on 05/11/2024.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"118"},"PeriodicalIF":2.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953617","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":"The diagnostic role of FNA based on clinicopathological features in thyroid malignancy.","authors":"Mohammad Mehdi Fallahi, Sepehr Koulaian, Parviz Mardani, Seyed Ali Malekhosseini, Reza Shahriarirad","doi":"10.1186/s12902-025-01945-w","DOIUrl":"https://doi.org/10.1186/s12902-025-01945-w","url":null,"abstract":"<p><strong>Background: </strong>Thyroid nodules are mostly benign lesions within the thyroid, with a small percentage being malignant. The decision for surgery is mainly based on the fine needle aspiration (FNA) cytology report, which is categorized into six categories from non-diagnostic to malignant. The accuracy of FNA is of utmost importance to minimize the complications due to misdiagnosis.</p><p><strong>Methods: </strong>In a retrospective study, we analyzed 310 patients who underwent thyroidectomy due to suspicious thyroid nodules with both FNA and histopathological results. We reviewed patient files, extracting demographic data, FNA results, and final histopathology reports and grouped them based on the size of the nodules. Sensitivity, specificity, and predictive values were calculated.</p><p><strong>Results: </strong>The average age of the patients was 42.9 ± 13.2 years, and the average size of the largest nodule diameter was 2.1 ± 1.89 cm. Histopathological evaluation of specimens obtained during surgery showed that 184 (59.4%) samples were malignant and 126 (40.6%) were non-malignant. The overall specificity was 96.8%, and the sensitivity was 89.6%, and the accuracy of FNA in diagnosing malignancy was 92.2%. Logistic regression analysis revealed that Bethesda classification (OR: 2.34; 95%CI: 1.73-3.16; P < 0.001), and also tumor size (OR: 2.02; 95%CI: 1.32-3.10; P = 0.001) exhibited a significant direct correlation with the capability of FNA in accurately diagnosing malignancy. The highest FNA accuracy of malignancy detection was among nodules above 3 cm (97.1%) while in nodules smaller than 1 cm the accuracy was 73.2%.</p><p><strong>Conclusion: </strong>FNA is a suitable diagnostic tool for detecting malignant nodules, while diagnostic capability varies with approaches to indeterminate FNA results. False positive and negative rates are crucial, with challenges in diagnosing malignancy in the context of multinodular goiter cases and smaller nodules.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"119"},"PeriodicalIF":2.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974735","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":"Neutrophil-lymphocyte ratio (NLR); an accurate inflammatory marker to predict diabetic foot ulcer amputation: a matched case-control study.","authors":"Faeze Afshar, Morteza Daraie, Fatemeh Mohammadi, Kiana Seifouri, Samira Amin Afshari, Soheil Heidari Some'eh, Amirhossein Yadegar, Parnian Naghavi, Alireza Esteghamati, Soghra Rabizadeh, Mahsa Abbaszadeh, Manouchehr Nakhjavani, Sahar Karimpour Reyhan","doi":"10.1186/s12902-025-01941-0","DOIUrl":"https://doi.org/10.1186/s12902-025-01941-0","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot ulcer (DFU) is a well-known complication of diabetes. The main therapeutic options for treating DFU include surgical debridement. However, conditions such as sensory loss and insufficient blood supply can lead to lower extremity amputations. Inflammatory biomarkers, including the neutrophil‒lymphocyte ratio (NLR) and platelet‒lymphocyte ratio (PLR), have shown promise in predicting the development of diabetes complications.</p><p><strong>Methods: </strong>This study included 126 individuals with known DFUs who underwent amputation or debridement surgery during hospitalization between January 2017 and December 2022. The participants were divided into two groups, each containing 63 patients, based on the treatment they received. Analyses were conducted via univariate and multivariate regression models. The linearity of the relationship between each inflammatory index and the risk of amputation was further examined via restricted cubic spline (RCS) curves with four knots.</p><p><strong>Results: </strong>Categorical regression analysis showed an elevated risk of amputation in patients with an NLR greater than 6.08, with an OR of 13.090 (95% CI: 5.143-33.320, P < 0.001), compared with those with an NLR less than 6.08. Additionally, patients with a PLR greater than 210 demonstrated a similarly elevated risk of amputation with an OR of 2.31 (95% CI: 1.066‒4.669, P = 0.033); however, those with lymphocyte‒white blood cell ratio (LWR) levels of greater than 0.1265 exhibited reduced likelihood of having amputation (OR: 0.092 (95% CI: 0.038‒0.226, P < 0.001)).</p><p><strong>Conclusions: </strong>This study supports that NLR, PLR and LWR may have value as a predictive marker for amputation in patients with DFUs.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"120"},"PeriodicalIF":2.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971520","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}