BMC Endocrine Disorders最新文献

{"title":"Prediction of cardiac autonomic dysfunction using heart rate response to deep breathing test among type 2 diabetes mellitus.","authors":"Sohini Raje, G Arun Maiya, Padmakumar R, Mukund A Prabhu, Krishnananda Nayak, K N Shivashankara, B A Shastry, Megha Nataraj, Shreemathi S Mayya","doi":"10.1186/s12902-025-01939-8","DOIUrl":"https://doi.org/10.1186/s12902-025-01939-8","url":null,"abstract":"<p><strong>Background: </strong>Cardiac autonomic neuropathy (CAN) is an underdiagnosed complication of type 2 diabetes mellitus (T2DM) and a predictor of mortality and cardiovascular morbidity. Hence, CAN screening is essential. The objective of the study was to examine whether cardiac autonomic dysfunction can be predicted using the heart rate response to deep breathing test of cardiac autonomic reflex tests (CARTs) among type 2 diabetes mellitus.</p><p><strong>Methods: </strong>The study was a cross-sectional study of T2DM individuals between 40 and 65 years. Each participant underwent a heart rate (HR) response to deep breathing test (CARTs) as per standard guidelines. ANOVA F-test was used to check the difference between the CAN severity and the heart rate response to deep breathing parameters. A post-hoc (Tukey's) test was used to check which groups showed the difference.</p><p><strong>Results: </strong>Eighty-four participants were screened, of which forty-one were included in the present study. The mean age of the participants was 58.8 ± 4.0 years. The Fisher's test showed a statistically significant difference between groups for the average deep breathing difference (F(3,27) = 16.09, p < 0.001) and the respiratory sinus arrhythmia index (F(3,27) = 7.35, p < 0.001).</p><p><strong>Conclusion: </strong>HR response to deep breathing can be used as a preliminary tool to screen CAN in T2DM to differentiate between normal and the other stages of CAN, which can then be followed by the gold standard tests. Further studies are required to establish HR response to deep breathing as a singular tool using regression analysis.</p><p><strong>Clinical trials registration: </strong>The study was registered prospectively in the Clinical Trials Registry- India (CTRI/2023/11/060077) on 21st November 2023.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"117"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976672","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":"Impact of intraoperative intact PTH monitoring on reoperation rates and surgical success in primary hyperparathyroidism.","authors":"Farshad Noori, Erdal Güceoğlu, Yunushan Furkan Aydoğdu, Çağrı Büyükkasap, Ramazan Kozan, Kürşat Dikmen, Özlem Gülbahar, Murat Akın, Ömer Şakrak","doi":"10.1186/s12902-025-01942-z","DOIUrl":"https://doi.org/10.1186/s12902-025-01942-z","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT) is caused by excessive parathormone secretion from one or more parathyroid glands. The primary treatment for PHPT is surgery. Due to anatomical variations in the parathyroid glands, preoperative localization, surgical approaches, and success rates can vary. With the development of advanced imaging techniques and the introduction of intraoperative intact PTH (i-PTH) measurement, traditional extended surgical approaches have increasingly been replaced by focused surgeries.</p><p><strong>Objective: </strong>Intraoperative i-PTH measurement has been applied by different surgeons using various criteria. This study aims to evaluate the effectiveness of intraoperative i-PTH measurement in improving surgical success, particularly in cases with inconclusive preoperative imaging results.</p><p><strong>Methods: </strong>Between January 2010 and September 2020, 203 adult patients who underwent surgery for PHPT in our clinic were included in the study. Patients were categorized into two groups: Group A (with intraoperative i-PTH measurement) and Group B (without i-PTH measurement). Persistent hyperparathyroidism was defined as elevated calcium levels occurring shortly after surgery, whereas recurrence was defined as calcium elevation after the 6th postoperative month. The absence of recurrence or persistent hypercalcemia was considered an indicator of surgical success.</p><p><strong>Results: </strong>The mean age of the patients was 54.6 ± 12.7 years. Of the 203 patients, 40 (19.7%) were male and 163 (80.3%) were female. No correlation was found between recurrence or persistence and patient age. The overall success rate was 93.6%. Surgical success was achieved in 97.8% of patients in Group A and 90% in Group B, indicating a statistically significant difference between the groups (p = 0.023).</p><p><strong>Conclusion: </strong>Intraoperative i-PTH measurement significantly increases the success rate of PHPT surgery, reducing the incidence of recurrent or persistent cases and the need for secondary operations. Consequently, it helps prevent complications associated with reoperations. These findings highlight the pivotal role of intraoperative i-PTH monitoring in optimizing surgical outcomes, especially in complex PHPT cases.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"116"},"PeriodicalIF":2.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964433","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":"Mediating effect of TyG index on the association between glucose-lipid metabolism-related dietary pattern and T2DM: a propensity score-matched analysis.","authors":"ShuShu Li, Rong Xia, Xing Gong, Chao Wang, Hechun Liu, Huibin Dong, Zhangyao Su, Yucheng Liang, Shoulin Wang, Tao Yang","doi":"10.1186/s12902-025-01892-6","DOIUrl":"https://doi.org/10.1186/s12902-025-01892-6","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association of dietary patterns (DPs) with risk of T2DM, emphasizing the intermediary role of HOMA or TyG indices among a Chinese adult population.</p><p><strong>Research design and methods: </strong>Directed acyclic graphs combined with propensity score matching were used to minimize confounding, resulting in 1330 subjects for final analysis. Principal component analysis and reduced rank regression, applied to eleven food groups. Multivariable logistic regression and restricted cubic spline regression models were used to assess associations between there DPs with prevalent T2DM, as well as insulin resistance and β-cell function (HOMA-TyG). Mediation analyses were conducted to evaluate whether the HOMA-TyG index mediated the relationship between DPs and T2DM.</p><p><strong>Results: </strong>The DP1, characterized by high intakes of poultry, meat, and preserved foods, was associated with elevated body mass index, triglycerides, and hemoglobin A1c. Both PCA-DP1(OR_Q4VsQ1 = 2.15, 95% CI: 1.53-3.03) and RRR-DP1 (OR_Q4VsQ1 = 1.69, 95% CI: 1.82-3.58) were significantly positively correlated with T2DM. RRR-DP1 additionally demonstrated a dose-dependent relationship with HOMA-insulin resistance and TyG. Furthermore, the TyG index mediated approximately 19.51% of the relationship between RRR-DP1 and T2DM.</p><p><strong>Conclusions: </strong>These findings indicate that glucose-lipid metabolism-related dietary pattern, notably high in animal fat, exacerbates insulin resistance and heightens T2DM risk. Tailoring dietary interventions to modify this pattern may be an effective strategy for preventing and managing T2DM.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"114"},"PeriodicalIF":2.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953491","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 between glucose time-in-range and the severity of metabolic dysfunction-associated steatotic liver disease in Chinese adults with type 2 diabetes mellitus.","authors":"Chun-Hua Wang, Xuan-Yao Ji, Nian Ji, Qing-Feng Yan, Hong-Qing Xu, Xue-Qin Wang, Xiang-Fan Chen, Chun-Feng Lu","doi":"10.1186/s12902-025-01937-w","DOIUrl":"10.1186/s12902-025-01937-w","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the correlation between glucose time-in-range (TIR) and hepatic steatosis severity or liver fibrosis risk in Chinese adults with type 2 diabetes mellitus (T2DM) comorbid with metabolic dysfunction-associated steatotic liver disease (MASLD).</p><p><strong>Methods: </strong>Participants with T2DM were evaluated for hepatic steatosis and fibrosis using vibration-controlled transient elastography. TIR was calculated based on data from a retrospective continuous glucose monitoring system.</p><p><strong>Results: </strong>A total of 184 T2DM patients with MASLD were enrolled. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) decreased with increasing TIR (p < 0.05). Spearman correlation showed negative correlations between CAP, LSM, and TIR (r = -0.824 and - 0.842, p < 0.05) and positive correlations with basal insulin resistance (HOMA-IR) (r = 0.205 and 0.208, p < 0.01). Multiple linear regression revealed TIR and HOMA-IR independently correlated with CAP (std. regression coefficients = -0.695 and 0.103, p < 0.05) and LSM (std. regression coefficients = -0.735 and 0.083, p < 0.05), wit0.34 h TIR having a stronger impact. Binary logistic regression showed TIR Groups 3 (70% ≥ TIR < 85%) and 4 (TIR ≥ 85%) were protective for MASLD (OR = 0.26 and 0.11, 95% CI 0.10-0.66 and 0.04-0.29, P = 0.005 and < 0.001) and liver fibrosis (OR = 0.29 and 0.13, 95% CI 0.12-0.74 and 0.05-0.36, P = 0.010 and < 0.001) compared to TIR Group 1 (lowest quartile).</p><p><strong>Conclusion: </strong>In T2DM patients with coexisting MASLD, a significant and independent association existed between TIR and the severity of hepatic steatosis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"113"},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974694","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":"SGLT2 inhibitor in a type 2 diabetes mellitus patient coexisted with central diabetes insipidus following hyperosmolar hyperglycemic state.","authors":"Shu Liu, Wenqiang Chen, Yanru Zhao, Shaohui Ma, Bingyin Shi, Hui Guo","doi":"10.1186/s12902-025-01924-1","DOIUrl":"https://doi.org/10.1186/s12902-025-01924-1","url":null,"abstract":"<p><strong>Background: </strong>Central diabetes insipidus (CDI) is a rare complication following a hyperglycemic hyperosmolar state (HHS) in patients with type 2 diabetes mellitus (T2DM). The coexistence of T2DM and CDI can lead to diagnostic challenges, particularly when the patients present with persistent hypernatremia without a sense of thirst.</p><p><strong>Case presentation: </strong>This case report describes a young woman with T2DM and HHS who developed persistent hypernatremia without thirst. The diagnosis of CDI was delayed until she exhibited polydipsia, consuming up to 10 L of water per day, following the administration of dapagliflozin for glucose control. Initially, the low specific gravity of urine was not evident during dapagliflozin treatment. However, after discontinuing dapagliflozin for 48 h, CDI was confirmed through a water deprivation test, which revealed polyuria with low urine specific gravity and osmolality. The patient was successfully treated with oral desmopressin.</p><p><strong>Conclusions: </strong>This case highlights that SGLT2 inhibitors, such as dapagliflozin, may accelerate polyuria and alter urine osmolality by inhibiting glucose and sodium reabsorption in the proximal tubular. Therefore, it is crucial to discontinue SGLT2 inhibitors when CDI is suspected or diagnosed.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"112"},"PeriodicalIF":2.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980502","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":"Hypothyroidism phenotypes, clinical characteristics, and factors associated with nodular thyroid disease in patients with hypothyroidism in Southern Ghana: a 6-year retrospective study.","authors":"Samuel Ametepe, Brian Yaw Entsiey Nyarko, Isaac Wormekpor, Bright Kantah, Michael Appiah, Precious Kwablah Kwadzokpui, Esther Ngozi Adejumo, Christian Obirikorang, Abigail Ibrahim, Belinda Ampomah Kwarteng, Eric Ny Nyarko, James Osei-Yeboah, Sylvester Yao Lokpo","doi":"10.1186/s12902-025-01934-z","DOIUrl":"https://doi.org/10.1186/s12902-025-01934-z","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to describe the frequency of hypothyroidism phenotypes, clinical characteristics, and factors associated with nodular thyroid among hypothyroid patients at the University of Ghana Hospital in southern Ghana.</p><p><strong>Methods: </strong>This study was a 6-year hospital-based retrospective study that extracted data from 221 patients with hypothyroidism from the archival records of the University of Ghana Hospital using a checklist. These include socio-demography (age, gender, marital status, residential status, educational level), lifestyle variables (anthropometry, smoking status, alcohol intake), and co-morbidities, as well as ultrasound imaging findings of the thyroid. Serum thyroid hormone levels were used to classify hypothyroidism phenotypes. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with nodular thyroid disease.</p><p><strong>Result: </strong>The frequency of primary, subclinical, and secondary hypothyroidism was 81.4%, 16.3%, and 2.3%, respectively. Fatigue [120(54.3%)], heavy menstrual loss [54/160(33.8%)], and cold intolerance [73(33.0%)], were predominant symptoms while 54/57 (94.7%) were overweight/obese, 23/32 (71.9%) had dyslipidaemia whereas 7/34 (20.6%) had hypertension. The odds of developing nodular thyroid disease were 2.11 times higher (95% CI: 1.07-4.17; p = 0.032) in males than in females.</p><p><strong>Conclusion: </strong>Our results provide insight into the frequency of hypothyroidism phenotypes, clinical characteristics, and factors associated with nodular thyroid, emphasizing male gender as an independent predictor of nodular thyroid disease. Our findings also emphasize the need for lifestyle adjustment as a mitigating strategy in the management of hypothyroidism. However, prospective studies are required to confirm the findings or investigate the histological characteristics of thyroid nodules in patients with hypothyroidism.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"111"},"PeriodicalIF":2.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12013080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981466","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 between triglyceride glucose index and depression in polycystic ovary syndrome.","authors":"Guili Chen, Lin Zhu, Ying Lou, Yingyun Wu, Lanying Wang, Weirong Mao, Jianting Ma","doi":"10.1186/s12902-025-01927-y","DOIUrl":"https://doi.org/10.1186/s12902-025-01927-y","url":null,"abstract":"<p><strong>Objective: </strong>The relationship between the triglyceride glucose (TyG) index and the incidence of depression in populations with polycystic ovary syndrome (PCOS) remains unclear. This study aims to investigate the relationship between the TyG index and depression incidence in PCOS populations.</p><p><strong>Methods: </strong>We conducted a study on 725 women aged 18 to 45 who visited our hospital from January 2021 to December 2023. Demographic and anthropometric data were collected, and serum assays were performed. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess the past week's feelings and determine depression status. Statistical methods such as binary logistic regression analysis were used to analyze the relationship between the TyG index, Homeostatic model assessment insulin resistance index(HOMA-IR), and depression in PCOS patients. The TyG index, HOMA-IR, was tested for its ability to predict depression using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>In logistic regression models, a significant positive association was observed between the TyG index and depression after the adjusted analysis(4.552(2.975 ∼ 6.966), P<0.001). Compared to HOMA-IR(1.224(1.122 ∼ 1.336), P<0.001), the TyG index was a more significant risk factor for depression. ROC analysis showed that the AUC of the TyG index(0.724, 0.684 ∼ 0.765) was higher than the HOMA-IR(0.698,0.656~0.74).</p><p><strong>Conclusions: </strong>A high TyG index was associated with higher odds of having depression in the population with PCOS. This indicated that the TyG index may be an independent predictor of depression development.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"108"},"PeriodicalIF":2.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974168","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 impact of vitamin D supplementation on glycemic control and lipid metabolism in polycystic ovary syndrome: a systematic review of randomized controlled trials.","authors":"Miao Yu, Shuai Chen, Xia Liu, Hui Dong, Deng-Chao Wang","doi":"10.1186/s12902-025-01920-5","DOIUrl":"https://doi.org/10.1186/s12902-025-01920-5","url":null,"abstract":"<p><strong>Background: </strong>Polycystic ovary syndrome (PCOS) is a prevalent endocrine condition affecting both metabolic and reproductive health in women. The impact of vitamin D on metabolic regulation has attracted growing interest. The purpose of this study is to investigate the impact of vitamin D supplementation on key metabolic parameters-namely blood glucose, insulin, and lipid levels-in individuals with PCOS.</p><p><strong>Methods: </strong>A systematic review was conducted to identify relevant studies in PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. The search focused on randomized controlled trials (RCTs) evaluating the impact of vitamin D supplementation in patients with PCOS. Meta-analysis was performed using RevMan 5.3 software, and study quality was evaluated with the Cochrane Risk of Bias Tool. In addition, outcome-related evidence was graded using the GRADE system, and TSA was performed to determine if the number of participants met the required threshold.</p><p><strong>Results: </strong>A total of 691 individuals with PCOS from 13 RCTs were evaluated. The meta-analysis indicated that the supplementation of vitamin D led to a notable reduction in the subsequent metabolic parameters: fasting blood glucose[MD=-2.91 mg/dL, 95% CI (-4.78, -1.04) mg/dL, P = 0.002], insulin levels[MD=-1.98 µIU/mL, 95% CI (-3.32, -0.64) µIU/mL, P = 0.004], triglycerides[MD=-11.01 mg/dL, 95% CI (-16.42, -5.61) mg/dL, P < 0.0001], total cholesterol [MD=-11.69 mg/dL, 95% CI (-15.56, -7.82) mg/dL, P < 0.00001], very low-density lipoprotein cholesterol (VLDL-cholesterol) [MD=-2.64 mg/dL, 95% CI (-4.50, -0.79) mg/dL, P = 0.005], and low-density lipoprotein cholesterol (LDL-cholesterol) [MD=-5.85 mg/dL, 95% CI (-10.28, -1.42) mg/dL, P = 0.010]. Nevertheless, the supplementation of vitamin D did not exert a significant impact on high - density lipoprotein cholesterol (HDL - cholesterol) [MD=-0.21 mg/dL, 95% CI (-0.81, 1.22) mg/dL, P = 0.69]. Begg's and Egger's tests suggested a minimal probability of publication bias, and the TSA confirmed that the optimal sample size for major outcomes had been reached, supporting the robustness of the meta-analysis results.</p><p><strong>Conclusion: </strong>Vitamin D supplementation shows significant benefits in improving metabolic parameters in PCOS patients, particularly in reducing fasting blood glucose, insulin, and lipid levels, suggesting a potential role of vitamin D in PCOS management. The long-term outcomes and most effective dose of vitamin D warrant further investigation in future research.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"110"},"PeriodicalIF":2.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954466","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":"Recurrent education: A promising strategy for enhancing diabetes management and reducing hypoglycemia in children with type 1 diabetes.","authors":"Didem Güneş Kaya, Elvan Bayramoğlu, Hande Turan, Enes Karaca, Göktuğ Zorbay Eyüpoğlu, Betül Zehra Pirdal, Saadet Olcay Evliyaoğlu","doi":"10.1186/s12902-025-01917-0","DOIUrl":"https://doi.org/10.1186/s12902-025-01917-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the impact of recurrent individualized education on the management of hypoglycemia, hypoglycemia awareness, and metabolic control of diabetes in children and adolescents living with type 1 diabetes (T1D).</p><p><strong>Methods: </strong>A prospective quantitative study involving participants aged 8 to 18 years with T1D was conducted. Three established hypoglycemia screening tools were employed: the Hypoglycemia Fear Survey (HFS), the Gold Hypoglycemia Awareness Questionnaire, and the Edinburgh Hypoglycemia Symptoms Scale. The participants used blinded continuous glucose monitoring (b-CGM) devices to document glucose values, meals, insulin doses, exercise periods, symptomatic hypoglycemia episodes, and glucose levels during hypoglycemia, experienced symptoms, and treatment approaches for hypoglycemia. Following this initial phase, the participants received education from healthcare professionals. The same procedures were repeated six weeks after the educational intervention.</p><p><strong>Results: </strong>Prior to education, approximately half (n = 21) of the 47 participants were present with impaired hypoglycemia awareness (IHA), and half of the IHA group applied the appropriate hypoglycemia self-treatment. After education, almost all participants demonstrated an improved ability to manage hypoglycemia effectively. Following education, improvements in the frequency of fingerstick glucose measurement per day, time spent within the target glucose range (70-180 mg/dL), glycemic variability (GV), hypoglycemia perception, appropriate hypoglycemia self-treatment, and hypoglycemia fear were observed, both in participants with hypoglycemia awareness and those with IHA.</p><p><strong>Conclusions: </strong>The results indicate that children and adolescents living with T1D benefit from recurrent self-management education. The benefits were observed in both participants with hypoglycemia awareness and those with IHA. Education positively impacts diabetes management and enhances hypoglycemia awareness.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"109"},"PeriodicalIF":2.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971588","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 between thyroid stimulating hormone levels and nonproliferative diabetic retinopathy: a cross-sectional study.","authors":"Yiqi Xu, Biwu Dong, Youyun Tang, Yan Jiang, Tingting Huang, Feng Jiang, Wei Xing, Junsheng Chen, Fengping Zhu","doi":"10.1186/s12902-025-01928-x","DOIUrl":"https://doi.org/10.1186/s12902-025-01928-x","url":null,"abstract":"<p><strong>Background: </strong>The association between thyroid-stimulating hormone (TSH) and type 2 diabetes mellitus (T2DM) is well known. However, whether TSH is related to nonproliferative diabetic retinopathy (NPDR) has not been studied. This study aimed to explore the relationship between TSH and NPDR in Chinese patients with T2DM.</p><p><strong>Methods: </strong>In this cross-sectional study, 427 patients with T2DM were enrolled. The individuals were classified into two groups according to the fundus oculi examination: the non-diabetic retinopathy (NDR) group (n = 224) and the non-proliferative diabetic retinopathy (NPDR) group (n = 203). The individuals' demographic and clinical data were collected by reviewing medical records and direct interviews. The demographic data and biochemical parameters were compared between groups using the Student's t - test or the Mann‒Whitney U test, anthropometric measurements, thyroid function, and NPDR were evaluated, and the associations between TSH and NPDR were assessed using logistic regression models.</p><p><strong>Results: </strong>No significant differences in age, sex, body mass index (BMI), incidence of alcohol consumption, and duration of diabetes were found between these two groups. The systolic blood pressure (SBP), incidence of smoking, TSH, blood urea nitrogen (BUN), and urinary micro-albumin (mALB) were significantly higher in the NPDR group than in the NDR group (P < 0.05). Individuals in the NDR group had higher levels of thyroxine (T4), glutamic pyruvic transaminase (ALT), fasting C-peptide (FCP), and 2-hour C-peptide (2hCP) than individuals in the NPDR group (P < 0.05). Spearman's correlation analysis revealed that the serum TSH levels were negatively associated with the HbA1c levels in all patients (r=-0.11, P < 0.05). Serum TSH levels were negatively correlated with HbA1c levels (r = -0.19, P < 0.01) and positively correlated with diabetes duration (r = 0.14, P < 0.05) in the NPDR group. Multivariate logistic regression analysis revealed that high TSH levels, sex, diabetes duration, high-density lipoprotein cholesterol (HDL-C), glycosylated hemoglobin (HbA1c), FCP, and SBP were associated with NPDR [odds ratio (OR) > 1, P < 0.05]. Receiver operating characteristic curve analysis revealed that the optimal cutoff point of TSH for predicting NPDR was 2.235 mIU/L.</p><p><strong>Conclusion: </strong>The TSH level is independently associated with NPDR in the Chinese population with T2DM. A high serum TSH level may be a potential risk factor for NPDR and an indicator for screening for diabetic microangiopathy.</p><p><strong>Trial registration: </strong>This study is registered with the Chinese Clinical Trial Registry (02/21/2025 ChiCTR2500097614).</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"25 1","pages":"106"},"PeriodicalIF":2.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984285","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}