BMC Endocrine Disorders最新文献

{"title":"Current status of anti-obesity medications and performance, an EHR based survey.","authors":"Xiaoyang Ruan, Rui Li, Liwei Wang, Shuyu Lu, Andrew Wen, Murali Sameer, Hongfang Liu","doi":"10.1186/s12902-026-02423-7","DOIUrl":"10.1186/s12902-026-02423-7","url":null,"abstract":"<p><strong>Background: </strong>While randomized clinical trials (RCTs) establish the efficacy of anti-obesity medications (AOMs), their real-world effectiveness, inter-individual variability, and weight regain post discontinuation remain poorly characterized across diverse, large scale populations.</p><p><strong>Methods: </strong>Electronic health records with pharmacy dispensation of obesity or overweight individuals were retrieved from local UT-Physician and nationwide EPIC COSMOS databases. AOMs were analyzed for short to long-term effectiveness on obesity relevant metrics.</p><p><strong>Results: </strong>From the two cohorts, 71,318 (11·7%) and 1 M (27·9%) individuals documented AOM exposures, respectively, with about 70% individuals experiencing more than one treatment session. Tirzepatide and Semaglutide outperformed other AOMs and were associated with up to 9·6[IQR:11]% and 6·2[IQR:11]% weight loss, respectively, and both improved blood pressure, HbA1c, and lipid profile. The median exposure durations were approximately 4·6 months for the two GLP-1/GIP AOMs, far short of the 72-week duration typically required for peak therapeutic benefit in RCTs. All AOMs showed substantial inter-individual variability in responses, regardless of exposure length. Substantial differences were found between RCT and real-world performance. For example, while Tirzepatide led both cohorts, nearly 50% and 25% of individuals didn't achieve the 10% and 5% weight loss target respectively, after a minimum 72 weeks exposure, highlighting a notable effectiveness gap. Critically, we identified that Metformin co-therapy acted as a modifier of the 'rebound effect,' significantly attenuating (median 1·9 - 2·6%, p < 0.0001) weight regain compared to semaglutide or tirzepatide monotherapy.</p><p><strong>Conclusion: </strong>Our findings confirm real-world AOM effectiveness and reveal challenges of the 'one-size-fits-all' approach of current pharmacotherapy. The marked inter-individual variability suggests that stratified, personalized pharmacotherapy is essential to transform transient weight loss into sustainable metabolic health.</p><p><strong>Clinical trial: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223379","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":"Fasting insulin to HDL-C ratio is correlated with MASLD severity in Chinese overweight/obesity: a cross-sectional analysis.","authors":"Xiaojuan Xu, Xincheng Wang, Lulu Yu, Xiaotian Yang, Peiyao Wang, Yimeng Wang, Zhenyang Guan, Chunjun Li, Tao Han","doi":"10.1186/s12902-026-02424-6","DOIUrl":"10.1186/s12902-026-02424-6","url":null,"abstract":"<p><strong>Background: </strong>The fasting insulin to high-density lipoprotein cholesterol ratio (FINS/HDL-C) is a newly identified insulin resistance (IR) marker. And the correlation between FINS/HDL-C and metabolic dysfunction-associated steatotic liver disease (MASLD) has not yet been explored, our study investigated the association between FINS/HDL-C and MASLD severity.</p><p><strong>Methods: </strong>This cross-sectional study included 330 participants with overweight/obesity and MASLD. Demographic information and biochemical indicators were collected, and IR markers including FINS/HDL-C, homeostatic model assessment for insulin resistance (HOMA-IR), triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), and triglyceride glucose index (TyG), were calculated. MASLD severity was assessed using the controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) determined by FibroScan. The relationship between FINS/HDL-C and MASLD severity was evaluated and compared with that of other IR markers.</p><p><strong>Results: </strong>Participants with higher CAP and LSM exhibited significantly higher FINS/HDL-C (P < 0.05). Even in the fully adjusted linear regression model, FINS/HDL-C remains positively correlated with CAP (β = 0.33, 95% CI 0.09 ~ 0.58, P = 0.009) and LSM (β = 0.05, 95% CI 0.02 ~ 0.08, P < 0.001). And FINS/HDL‑C was the only biomarker that showed elevated CAP at Quartile 2. Exploratory analysis suggested that BMI might be involved in the association between FINS/HDL-C and CAP and LSM. FINS/HDL-C had the highest area under the receiver operating characteristic curve for severe hepatic steatosis, at 0.699 (95% CI: 0.639 ~ 0.758).</p><p><strong>Conclusions: </strong>Our findings suggest that FINS/HDL-C is associated with MASLD severity in overweight/obese individuals. It might serve as a valuable biomarker for MASLD risk stratification.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886564","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 copper exposure with metabolic syndrome: a dose-response meta-analysis.","authors":"Chou-Yi Hsu, Mohammed Hashim Mohammed, Sarah F Al-Taie, Jasur Rizaev, Meka Sreedhar Rao, Irwanjot Kaur, Neeraj Bainsal, Samir Sahoo, Aseel Smerat, Hamzeh Alizadeh","doi":"10.1186/s12902-026-02434-4","DOIUrl":"10.1186/s12902-026-02434-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic syndrome (MetS) represents a cluster of interconnected metabolic derangements with a growing global prevalence. The association of copper (Cu) exposure with the odds of MetS remains unclear. This dose-response meta-analysis aimed to examine the relationship between urinary and serum Cu concentrations and MetS.</p><p><strong>Methods: </strong>We searched Cochrane library, Web of Science, PubMed, and Scopus from inception to 4 February 2026. Studies providing association estimates for the relationship between serum or urinary Cu and MetS were included. Pooled effect sizes were presented as odds ratios (ORs) with 95% confidence intervals (CIs), calculated with the use of random-effects models.</p><p><strong>Results: </strong>Twenty-three studies with 69,121 participants and 9,964 MetS cases were included. Higher serum Cu concentrations were significantly linked to elevated odds of MetS (OR = 1.17, 95% CI = 1.02-1.35), with considerable heterogeneity (I² = 79.6%, P < 0.001). Dose-response analysis revealed no significant linear association; however, a significant non-linear relationship was identified, with the odds of MetS increasing more markedly at serum Cu concentrations above approximately 1,100 µg/L (P = 0.047). Higher urinary Cu concentrations were also significantly associated with greater odds of MetS (OR = 1.41, 95% CI: 1.03-1.95; I² = 83.1%). The associations for both serum and urinary Cu were attenuated after adjustment for lifestyle-related factors and BMI.</p><p><strong>Conclusions: </strong>Elevated serum and urinary Cu concentrations were significantly linked to an elevated odds of MetS, with evidence of a non-linear dose-response association. Lifestyle factors may confound this association.</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":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206483","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 ABO and Rh blood groups with clinicopathological features and lymph node involvement in surgically treated thyroid malignancies: a retrospective single-center study.","authors":"Ahmet Zahit Kaan, Murat Acar, Harun Çok, Serhan Yılmaz, Erkan Somuncu","doi":"10.1186/s12902-026-02433-5","DOIUrl":"10.1186/s12902-026-02433-5","url":null,"abstract":"<p><p>This study investigated the association between ABO and Rh blood group antigens and the clinicopathological features of 418 patients who underwent thyroidectomy for primary thyroid malignancy between December 2016 and June 2023. Since continuous variables did not follow a normal distribution (p < 0.05), data were presented as median and interquartile range (IQR). The distribution of ABO blood groups was A (44.5%), O (31.8%), B (16.0%), and AB (7.7%), with 90.9% of patients being Rh-positive. The median age of the cohort was 48 years (IQR: 19). While ABO groups showed no significant difference in age, Rh-negative patients were significantly older than Rh-positive patients (52.5 vs. 48.0 years; p = 0.027). No direct association was identified between ABO groups and the overall clinicopathological features such as tumor size or multifocality (p > 0.05). However, significant differences were observed regarding pathologically confirmed lymph node (LN) involvement. Pathologically confirmed LN involvement was significantly more prevalent in the Rh-negative group compared to the Rh-positive group (15.8% vs. 5.5%; p = 0.027). Most notably, a subgroup analysis revealed that patients with the AB blood group had a significantly higher rate of pathologically confirmed LN involvement compared to non-AB groups (15.6% vs. 5.7%; p = 0.028). To confirm the independence of this association, a multivariable logistic regression analysis was performed. After adjusting for potential confounders including age and tumor size, the AB blood group was independently associated with pathologically confirmed LN metastasis in an exploratory multivariable model (OR: 3.114, 95% CI: 1.085-8.938, p = 0.035). These findings suggest that while ABO and Rh blood groups are not significantly associated with most clinicopathological variables in this cohort, they demonstrate specific correlations with nodal disease. These findings may represent exploratory signals that warrant further validation, rather than clinically applicable biomarkers at this stage. Further multicenter prospective studies are warranted to validate these associations across all histological subtypes.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":"26 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219855","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 creatinine to body weight ratio with glycemic progression and remission in Chinese adults with prediabetes: a large-scale retrospective cohort study.","authors":"Hengchang Xu, Yueqin Gou, Wenhong Zhai, Bo Lu, Zhihui Ye, Dongni Sun, Weijia Xiao, Changchun Cao, Haohan Zhai, Haochuan Qiu","doi":"10.1186/s12902-026-02406-8","DOIUrl":"10.1186/s12902-026-02406-8","url":null,"abstract":"<p><strong>Objective: </strong>The creatinine-to-body weight ratio (Cre/BW) has been proposed as a practical surrogate marker of skeletal muscle mass. Emerging evidence highlights a notable correlation connecting Cre/BW to diabetes alongside various metabolic dysfunctions; however, its role in glycemic worsening and the restoration of normoglycemia in individuals with prediabetes has not been well defined. This study, therefore, examined the effect of Cre/BW on glycemic remission and progression among Chinese adults with prediabetes.</p><p><strong>Methods: </strong>A total of 24,506 adults with prediabetes from 11 cities in China were included in this retrospective cohort study based on health examination data. Cox proportional hazards models and subgroup analyses were used to estimate associations of Cre/BW with incident diabetes and remission to normoglycemia. Potential nonlinearity in these relationships was assessed by RCS analyses.</p><p><strong>Results: </strong>During an observation period spanning 2.9 years (median), 11,170 participants (45.58%) achieved remission to normoglycemia, and 2,641 (10.78%) progressed to diabetes. In multivariable-adjusted Cox models, higher Cre/BW was linked to a greater likelihood of remission (HR = 1.41, 95% CI: 1.28-1.55, p < 0.0001) and lower hazard of progression to diabetes (HR = 0.42, 95% CI: 0.35-0.52, p < 0.0001). RCS analyses indicated a nonlinear association between Cre/BW and diabetes progression: the HR was 0.29 (95% CI: 0.20-0.40) when Cre/BW was < 1.07 μmol/L/kg and increased to 0.66 (95% CI: 0.46-0.95) when Cre/BW was ≥ 1.07 μmol/L/kg. Subgroup analyses suggested that the effect of Cre/BW on glycemic remission was more pronounced in men and in participants aged 40-50 years; a stronger effect of Cre/BW on glycemic progression was also observed among those aged < 30 years (all interaction p < 0.05).</p><p><strong>Conclusion: </strong>In adults with prediabetes, Cre/BW was linked to bidirectional changes in glycemic status: higher Cre/BW was linked to a lower hazard of progression to diabetes and a greater likelihood of remission to normoglycemia.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547859","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":"Total parathyroidectomy versus total parathyroidectomy with autotransplantation for refractory secondary hyperparathyroidism: short-term biochemical outcomes and postoperative calcium supplementation burden.","authors":"Horng-Shiuan See, Kian-Hwee Chong, Yu-Tien Chen, Jia-Hui Chen, Chieh-Wen Lai","doi":"10.1186/s12902-026-02430-8","DOIUrl":"10.1186/s12902-026-02430-8","url":null,"abstract":"<p><strong>Background: </strong>Comparative studies of total parathyroidectomy (TPTX) and total parathyroidectomy with autotransplantation (TPTX + AT) have primarily emphasized biochemical control and recurrence, whereas longitudinal outpatient oral calcium requirements have been less frequently quantified. This study compared short-term biochemical outcomes and postoperative calcium supplementation burden after these two procedures for refractory secondary hyperparathyroidism (SHPT).</p><p><strong>Methods: </strong>We retrospectively analyzed a nonrandomized cohort of 80 patients with refractory SHPT who underwent parathyroidectomy between January and December 2021 (TPTX, n = 40; TPTX + AT, n = 40). Biochemical markers were evaluated preoperatively and at postoperative day 3 and at postoperative months 1, 3, and 6. The practical postoperative outcome was prescribed oral calcium carbonate burden (500-mg tablets/day) at discharge and at 3 and 6 months. Acute intravenous calcium use and calcitriol supplementation were also recorded.</p><p><strong>Results: </strong>Both groups achieved satisfactory short-term biochemical control without major perioperative complications. Operative time was longer in the TPTX + AT group (p = 0.015). Compared with the TPTX + AT group, the TPTX group had higher serum calcium at 3 and 6 months, lower phosphate at 1 and 3 months, and lower bone-specific alkaline phosphatase and intact parathyroid hormone at 3 and 6 months. Despite these biochemical differences, acute intravenous calcium use and outpatient oral calcium and calcitriol supplementation did not differ significantly between groups.</p><p><strong>Conclusions: </strong>TPTX and TPTX + AT yielded satisfactory short-term biochemical outcomes. TPTX + AT was associated with higher postoperative intact parathyroid hormone levels, compatible with greater postoperative parathyroid activity; however, no significant between-group difference in prescribed oral calcium or calcitriol supplementation burden through 6 months was detected. Because procedure allocation was nonrandomized, thymectomy practices differed, and follow-up was limited to 6 months, these findings are descriptive and do not establish procedural superiority or long-term recurrence risk.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13679228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547580","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 and diagnostic efficacy of waist-to-height ratio with glycemic control in young and middle-aged adults with early-onset type 2 diabetes mellitus.","authors":"Danfeng Shen, Hongping Xiong, Genqun Deng, Xinran Jiang, Qing Zeng","doi":"10.1186/s12902-026-02427-3","DOIUrl":"10.1186/s12902-026-02427-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the cross-sectional association between waist-to-height ratio (WHtR) and glycemic control among Chinese young and middle-aged adults with early-onset type 2 diabetes mellitus (T2DM), and to evaluate the clinical value of WHtR as a screening indicator for early-onset T2DM.</p><p><strong>Methods: </strong>This single-center retrospective cross-sectional study enrolled 302 patients with early-onset T2DM (diagnosed at age ≥ 18 and < 40 years) who attended the Endocrinology Department of Fuzhou Second General Hospital between March 2023 and March 2024. Demographic, lifestyle, anthropometric, and glucolipid metabolic data were collected. WHtR and body mass index (BMI) were calculated. Patients were divided into three groups by tertiles of WHtR. Spearman correlation was used to explore the relationship between WHtR and glycemic parameters. Multivariate logistic regression was performed to verify the independent association between WHtR and poor glycemic control (glycated hemoglobin [HbA1c] ≥ 7.0%). Receiver operating characteristic (ROC), calibration, and decision curve analyses (DCA) were conducted to comprehensively assess the diagnostic performance and clinical utility of WHtR.</p><p><strong>Results: </strong>Among 302 included patients, 185 (61.3%) were male, with a mean age of 31.77 ± 8.63 years, mean HbA1c of 7.08 ± 1.23%, and mean WHtR of 0.55 ± 0.07. The poor glycemic control group (HbA1c ≥ 7.0%, n = 155) had significantly higher WHtR, BMI, fasting plasma glucose (FPG), and 2-hour postprandial plasma glucose (2 h-PPG) than the good control group (n = 147, all P < 0.001). Glycolipid metabolic parameters and diabetes distress scale (DDS) scores increased stepwise with rising WHtR tertiles (all P for trend < 0.01). WHtR was positively correlated with HbA1c (r = 0.464, P < 0.001), and the correlation strength was significantly higher than that of BMI (r = 0.320, P < 0.001). After adjustment for multiple confounders (including antidiabetic treatment regimens and diabetes duration), WHtR remained an independent factor associated with poor glycemic control (odds ratio [OR] = 5.80, 95% confidence interval [CI] 3.12-10.79, P < 0.001). The area under the curve (AUC) of WHtR for identifying poor glycemic control was 0.757, which was significantly higher than that of BMI (AUC = 0.675, P = 0.021), with acceptable discriminatory accuracy, calibration, and clinical net benefit.</p><p><strong>Conclusions: </strong>WHtR is closely associated with glycemic control in Chinese young and middle-aged adults with early-onset T2DM and shows acceptable screening and diagnostic performance for this population. WHtR is simple, non-invasive, and suitable for widespread use in primary clinical settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535307","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":"Early identification of cirrhosis risk in type 2 diabetes using the Fibrosis-4 index: evidence from a large U.S. cohort.","authors":"Mark W McGiffin, Patrick J Kiel, David R Foster, Kevin J Mumford, Gregory H Palmrose, Michael A Preston","doi":"10.1186/s12902-026-02375-y","DOIUrl":"10.1186/s12902-026-02375-y","url":null,"abstract":"<p><strong>Background & aims: </strong>Cirrhosis remains a leading cause of liver-related morbidity and mortality and is often diagnosed only at advanced stages. Individuals with type 2 diabetes mellitus (T2DM) are at increased risk, yet systematic screening for early fibrosis is rarely implemented. We evaluated whether the Fibrosis-4 (FIB-4) index, a widely used non-invasive biomarker, can identify elevated cirrhosis risk near the time of T2DM diagnosis.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using the NIH All of Us Research Program database. Adults with newly diagnosed T2DM and laboratory data for FIB-4 calculation within ± 365 days of diagnosis were included. Cases were participants who subsequently developed cirrhosis; controls were those who did not. FIB-4 distributions were compared using Wilcoxon rank-sum tests. Cox proportional hazards models assessed the association between FIB-4 and time to cirrhosis. Discriminative ability was evaluated using receiver operating characteristic (ROC) analysis, and Kaplan-Meier curves compared time-to-event outcomes by FIB-4 category.</p><p><strong>Results: </strong>Among 9,253 participants (136 cases, 9,117 controls), median FIB-4 was higher in cases (1.38; 95% CI: 1.25-1.48) than controls (1.00; 95% CI: 0.99-1.01; p < 0.001). Higher FIB-4 was associated with increased cirrhosis risk in Cox regression analyses (adjusted HR = 1.16 per 1‑unit increase; 95% CI 1.08-1.24; p < 0.001). ROC analysis yielded an AUROC of 0.66, indicating moderate discriminative ability, with an optimal cutoff of 1.23 derived for internal stratification. Kaplan-Meier analysis showed shorter time to cirrhosis for FIB-4 ≥ 1.23 (log-rank p < 0.001).</p><p><strong>Conclusions: </strong>FIB-4 measured near T2DM diagnosis may serve as an early signal for cirrhosis risk. Incorporating FIB-4 into diabetes care pathways could enable timely referral and intervention, improving long-term liver outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535266","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":"Escalating diabetes prevalence in pakistan: a qualitative study of endocrinologists' perspectives on contributing factors, management barriers, and strategies.","authors":"Muhammad Ebad Khan, Matti Ullah, Muhammad Usman Khan, Malaika Nasir, Irum Khan, Nayab Tariq, Owais Qarni, Zainab Ishtiaq, Azra Batool, Mahnoor Ajmal, Aqsa Abbasi, Alishba Bibi, Tanveer Afsar Malik, Sidra Hafeez","doi":"10.1186/s12902-026-02425-5","DOIUrl":"10.1186/s12902-026-02425-5","url":null,"abstract":"<p><strong>Background: </strong>Pakistan has one of the highest diabetes prevalence rates globally, yet limited research exists on endocrinologists' perspectives regarding drivers, barriers, and solutions.</p><p><strong>Methods: </strong>This qualitative study conducted semi-structured interviews with 21 endocrinologists across Islamabad, Rawalpindi, and Peshawar from March to April 2026. Purposive sampling was used to recruit participants. Inductive thematic analysis following Braun & Clarke's framework identified four main themes and nineteen subthemes.</p><p><strong>Results: </strong>Endocrinologists perceived a drastic rise in diabetes prevalence, with most estimating that one in three adults is now affected (based on their clinical observations) and reported a 50% increase in cases over 2-3 years and early onset type 2 diabetes in patients as young as 17-20 years. Urban-rural disparities were evident: urban areas have higher prevalence driven by sedentary lifestyles and unhealthy diets, while rural populations present with advanced disease and limited access to care. Factors contributing to diabetes prevalence included unhealthy dietary habits, sedentary lifestyle, obesity (with one participant estimating 52% central obesity), genetic predisposition, and stress/sleep disturbances. Major barriers comprised poor treatment adherence, financial constraints (insulin unaffordable for many), low health literacy (with most participants estimating approximately 98% of patients lacking basic knowledge), cultural misconceptions (insulin phobia, traditional remedies), medication shortages, and healthcare system limitations (2-3 min per patient). Strategies identified were patient education (with one participant estimating 80% of disease management), early screening, primordial prevention from childhood, government support for affordable medications, and the pharmacist as an underutilized diabetes educator.</p><p><strong>Conclusion: </strong>Pakistan faces an accelerating diabetes epidemic with a concerning shift to younger populations. Multi-level interventions addressing financial barriers, health literacy, cultural beliefs, systemic constraints, and expanding the pharmacist's role as educator are urgently needed.</p><p><strong>Clinical trial registration: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454705","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":"Near-final height outcomes in children with idiopathic short stature responsive to the IGF-1 generation test: a multicenter retrospective study of rhGH therapy.","authors":"Yavuz Özer, Hatice Ilgın Ruhi, Hande Turan, Melikşah Keskin, Sezgin Şahin, Veysel Nijat Baş, Zeynep Şıklar, Firdevs Baş, Zehra Aycan, Merih Berberoğlu, Büşra Hotaman, Ajlan Tükün, Feyza Darendeliler, Oya Ercan, Olcay Evliyaoğlu","doi":"10.1186/s12902-026-02418-4","DOIUrl":"10.1186/s12902-026-02418-4","url":null,"abstract":"<p><strong>Background: </strong>Children with idiopathic short stature (ISS) have reduced height potential without identifiable endocrine or systemic causes. Selecting appropriate candidates for recombinant human growth hormone (rhGH) therapy remains challenging. The aim of this study was to describe near-final height (NFH) outcomes and to identify clinical predictors of growth response in children with ISS who were selected for rhGH therapy based on a positive IGF-1 generation test (IGFGT).</p><p><strong>Methods: </strong>In this multicenter retrospective study (2009-2018) across four centers in Türkiye, patients diagnosed with ISS, baseline IGF-1 < 0 SDS, and ≥ 20% IGF-1 increment after IGFGT were included. GH1 gene sequencing was performed to exclude biologically inactive GH, a condition marked by normal or elevated GH secretion but impaired biological activity. NFH was defined as bone age ≥ 14 years in girls and ≥ 16 years in boys. Height SDS gain from baseline to NFH was evaluated.</p><p><strong>Results: </strong>Sixty-three patients (28 females, 19 pubertal) were enrolled, of whom 55 had NFH data and were included in the final analysis. Mean age at treatment initiation was 10.8 ± 3.0 years. No GH1 mutations were identified. Among 55 patients with NFH data, mean height SDS increased from - 2.90 ± 0.77 at baseline to -1.92 ± 0.90 at NFH (p < 0.001), with a mean height SDS gain of 0.93 ± 0.68. The median difference between NFH SDS and baseline predicted adult height (PAH) SDS was - 0.06 (- 0.32-0.07). Predictors of NFH gain included female gender, target height (TH) SDS, baseline height-TH difference, baseline height-PAH difference, and first-year growth velocity SDS.</p><p><strong>Conclusion: </strong>rhGH therapy was associated with improvements in height SDS and NFH in this selected cohort of children with ISS. However, the absence of an untreated control group and the minimal difference between NFH and baseline PAH indicate that these findings should be interpreted with caution. Although no GH1 mutations were identified, the relatively high rate of parental consanguinity suggests that other genetic factors within the GH-IGF-1 axis or epiphyseal growth plate pathways may underlie the etiology of short stature.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468992","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}