BMC Endocrine Disorders最新文献

{"title":"Effect of short-term tirzepatide treatment on mean platelet volume in patients with obesity: a retrospective controlled study.","authors":"Fatih Demircan, Omer Vefik Ozozan, Nevzat Gozel","doi":"10.1186/s12902-026-02422-8","DOIUrl":"10.1186/s12902-026-02422-8","url":null,"abstract":"<p><strong>Objective: </strong>Obesity is associated with chronic low-grade inflammation, increased cardiovascular risk, and alterations in platelet indices [1-5]. Mean platelet volume (MPV) is an easily obtainable surrogate marker that has been linked to platelet activation and inflammatory burden [4, 6-8]. This study evaluated whether short-term tirzepatide therapy was associated with changes in MPV in patients with obesity compared with an untreated control group.</p><p><strong>Methods: </strong>In this retrospective controlled study, 60 adults with obesity were included: 30 patients who received tirzepatide for two months and 30 untreated controls followed during the same period. Demographic data, body mass index (BMI), and MPV values at baseline and at two months were obtained from electronic medical records. Within-group changes were assessed using paired tests. Between-group comparisons of change scores were performed, and multivariable linear regression was used to evaluate the association between tirzepatide treatment and MPV change after adjustment for baseline BMI, baseline MPV, age, and sex.</p><p><strong>Results: </strong>Baseline BMI and MPV were comparable between the tirzepatide and control groups (BMI: 40.22 ± 4.10 vs. 39.86 ± 3.49 kg/m², p = 0.713; MPV: 10.65 ± 0.87 vs. 10.18 ± 1.30 fL, p = 0.105). In the tirzepatide group, BMI decreased significantly from 40.22 ± 4.10 to 36.30 ± 3.90 kg/m² (mean change - 3.92 kg/m², 95% CI -5.93 to -1.91; p < 0.001), and MPV decreased from 10.65 ± 0.87 to 9.72 ± 1.17 fL (mean change - 0.94 fL, 95% CI -1.44 to -0.44; p < 0.001). The between-group difference in MPV change was significant (mean difference - 1.35 fL, 95% CI -2.22 to -0.48; p = 0.003). In adjusted regression, tirzepatide treatment remained independently associated with greater MPV reduction (beta - 1.13, 95% CI -1.97 to -0.29; p = 0.009).</p><p><strong>Conclusion: </strong>Short-term tirzepatide treatment was associated with significant reductions in BMI and MPV compared with untreated controls. Because of the retrospective design, short follow-up, and absence of direct inflammatory and platelet-function biomarkers, these findings should be interpreted as hypothesis-generating rather than conclusive evidence of a direct platelet-modulating effect.</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/PMC13393939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468942","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 atherogenic index of plasma and MASLD in patients with type 2 diabetes: a cross-sectional study.","authors":"Aysun Seker, Seydahmet Akın","doi":"10.1186/s12902-026-02426-4","DOIUrl":"10.1186/s12902-026-02426-4","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is highly prevalent in patients with type 2 diabetes mellitus (T2DM). The atherogenic index of plasma (AIP), calculated as the logarithmic ratio of triglycerides to high-density lipoprotein cholesterol (HDL-C), reflects atherogenic dyslipidemia; however, its association with MASLD specifically in patients with T2DM remains insufficiently characterized.</p><p><strong>Methods: </strong>In this retrospective cross-sectional study, 216 adults with T2DM who underwent abdominal ultrasonography between January and September 2025 were evaluated. MASLD was diagnosed based on hepatic steatosis in the presence of metabolic dysfunction. Clinical, anthropometric, and biochemical variables were recorded. Comparative analyses, receiver operating characteristic (ROC) curve analyses, and multivariable logistic regression models were performed to assess the association between AIP and MASLD and to compare its performance with other non-invasive metabolic indices.</p><p><strong>Results: </strong>MASLD was identified in 163 patients (75.5%). Individuals with MASLD had higher body mass index (BMI), fasting glucose, triglycerides, uric acid, and AIP levels, and lower HDL cholesterol (all p < 0.01). ROC analysis demonstrated a modest discriminative ability of AIP for MASLD (AUC = 0.690, 95% CI 0.62-0.76, p < 0.001), with an optimal cutoff value of 0.068 yielding 66.9% sensitivity and 67.9% specificity. In logistic regression analyses, AIP showed a significant association with MASLD in both univariate analysis (OR 14.66, 95% CI 4.35-54.94, p < 0.001) and after adjustment for BMI and glycated hemoglobin (HbA1c) (OR 10.40, 95% CI 2.71-44.30, p < 0.001). Similarly, the triglyceride-glucose (TyG) index remained independently associated with MASLD in adjusted models (OR 2.81, 95% CI 1.54-5.43, p = 0.001), whereas Fatty liver index (FLI) and Hepatic steatosis index (HSI) were not significantly associated with MASLD.</p><p><strong>Conclusion: </strong>AIP was independently associated with MASLD in patients with T2DM; however, its discriminative performance was modest and did not exceed that of its individual lipid components. Therefore, AIP should be interpreted primarily as a composite indicator of atherogenic dyslipidemia rather than a standalone diagnostic marker for MASLD.</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/PMC13573354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468967","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":"Role of sRAGE in clinical heterogeneity and inflammation in endometriosis patients undergoing IVF; case-control study.","authors":"Neda Emami, Ashraf Moini","doi":"10.1186/s12902-026-02416-6","DOIUrl":"10.1186/s12902-026-02416-6","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a multifactorial, chronic inflammatory disorder that affects a substantial proportion of women during their reproductive years and is frequently associated with pelvic pain and infertility. Accumulating evidence suggests that advanced glycation end products (AGEs), generated through dietary exposure and oxidative stress, may contribute to disease progression by activating the receptor for AGEs (RAGE), thereby promoting inflammatory and fibrotic signaling pathways. Rather than serving as an initiating factor, the AGE-RAGE axis is increasingly recognized as an amplifier of persistent inflammation and lesion persistence in endometriosis. The soluble isoform of RAGE (sRAGE) acts as a circulating decoy receptor that sequesters AGEs and attenuates downstream pro-inflammatory cascades. Although dysregulated sRAGE concentrations have been documented in various metabolic and reproductive conditions, its specific role in endometriosis-particularly within the follicular microenvironment and in relation to inflammatory status-remains incompletely characterized.</p><p><strong>Methods: </strong>In this prospective case-control study, 71 women of reproductive age undergoing controlled ovarian stimulation and oocyte retrieval for in vitro fertilization (IVF) were enrolled. The case group included 40 women with confirmed endometriosis, while 31 women without endometriosis served as controls. Detailed clinical histories were obtained for both groups. Serum and follicular fluid samples were collected, and sRAGE concentrations were quantified using enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>No significant differences were observed between groups regarding age or body mass index. Both serum and follicular fluid sRAGE concentrations were significantly elevated in women with endometriosis compared with controls (both P < 0.001). Evaluation of clinical heterogeneity demonstrated significantly lower follicular fluid sRAGE levels among endometriosis women with concomitant allergic conditionsnull (P = 0.012). Within the endometriosis cohort, sRAGE concentrations did not vary significantly according to pain severity, including dysmenorrhea, pelvic pain, or dyspareunia. Likewise, no significant associations were identified with thyroid disorders, gastrointestinal disease, adenomyosis, migraine, asthma, diabetes, or multiple sclerosis. Furthermore, sRAGE levels were not correlated with the number of retrieved oocytes or embryos in either group.</p><p><strong>Conclusion: </strong>Women with endometriosis exhibited significantly elevated serum and follicular fluid sRAGE levels, suggesting altered AGE-RAGE axis activity. However, the absence of association with ovarian response indicates that sRAGE may reflect inflammatory status rather than reproductive outcomes.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic and hepatic differences among biochemically euthyroid individuals with distinct thyroid hormone sources: a comparative study.","authors":"Enver Ciftel, Filiz Mercantepe","doi":"10.1186/s12902-026-02421-9","DOIUrl":"10.1186/s12902-026-02421-9","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the associations between thyroid hormone profiles and derived ratios (particularly the T3/T4 ratio), body composition parameters, and markers of hepatic steatosis and fibrosis in biochemically euthyroid individuals with distinct thyroid physiologies. Specifically, we sought to compare patients without endogenous thyroid hormone production following total thyroidectomy, patients with Hashimoto's thyroiditis, and healthy controls.</p><p><strong>Method: </strong>In this retrospective, cross-sectional study, three groups with serum TSH levels within the reference range were included: (i) patients with hypothyroidism due to Hashimoto's thyroiditis (HT, n = 123), (ii) patients who had undergone total thyroidectomy (TT, n = 103) for benign conditions, and (iii) healthy control subjects (C, n = 83). Thyroid hormone levels and ratios (T3/T4, T3/TSH, T4/TSH), anthropometric measurements, body composition parameters, and non-invasive indices of hepatic steatosis and fibrosis (Fatty Liver Index (FLI) and Fibrosis-4 index (FIB-4)) were assessed in all participants.</p><p><strong>Results: </strong>The T3/T4 ratio differed significantly across groups (controls > HT > TT; p < 0.001). Both patient groups exhibited higher FLI (p = 0.019) and FIB-4 (p = 0.002) scores than controls. In correlation analyses, the T3/T4 ratio was positively associated with FIB-4 exclusively in the TT group (r = 0.263, p = 0.007). In hierarchical multiple regression restricted to TT patients, age independently predicted FIB-4 (β = 0.553, p < 0.001), whereas visceral fat rating was not significant (p = 0.476). After adjustment for age and visceral adiposity, the T3/T4 ratio remained an independent predictor of FIB-4 (β = 0.201, p = 0.016). Although TT patients showed less favorable body composition (higher fat mass and visceral adiposity; lower muscle and bone mineral percentages), these parameters did not independently predict FIB-4.</p><p><strong>Conclusion: </strong>These findings demonstrate that thyroid hormone balance is not homogeneous even under biochemically euthyroid conditions and that differences in functional thyroid capacity may translate into distinct metabolic and hepatic consequences. Thyroid hormone ratios may therefore provide complementary clinical information, supporting a more tissue-oriented approach to the evaluation of the thyroid-liver axis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13465065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454667","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":"Circulating spexin levels in women with PCOS (PMOS): relationships with phoenixin, BMI and perceived stress.","authors":"Ekaterina Babadzhanova, Boris Tilov, Delyana Davcheva, Tanya Deneva, Daniela Babadzhanova, Maria Orbetzova","doi":"10.1186/s12902-026-02409-5","DOIUrl":"10.1186/s12902-026-02409-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Polycystic ovary syndrome (PCOS), for which the term polyendocrine metabolic ovarian syndrome (PMOS) has recently been proposed to better reflect its complex endocrine and metabolic nature, is a common endocrine disorder associated with metabolic disturbances, including insulin resistance and obesity, chronic anovulation and impaired fertility. Its pathogenesis is complex and multifactorial, involving interrelated mechanisms such as impaired insulin action and compensatory hyperinsulinemia, neuroendocrine dysregulation, altered ovarian steroidogenesis and increased adrenal androgen production. Spexin and phoenixin are novel peptides, primarily produced in the hypothalamus, implicated in the regulation of energy homeostasis and reproductive function, but their role in PMOS remains insufficiently clarified. Emerging evidence suggests that women with PMOS experience higher levels of psychological distress, including anxiety, depression, and perceived stress, as assessed by validated instruments such as the Perceived Stress Scale (PSS). Chronic stress may contribute to dysregulation of the hypothalamic-pituitary-adrenal axis and reproductive neuroendocrine pathways. Given their involvement in both metabolic and neuroendocrine regulation, spexin and phoenixin may represent potential mediators linking metabolic dysfunction and psychological stress in PMOS. However, data on their association with perceived stress in this population remain limited. The aim of the study is to investigate serum spexin levels in women with and without PMOS, the association of the novel neuropeptide with body mass index (BMI), perceived stress and the potential interrelationship between spexin and phoenixin.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study included 168 women of reproductive age, of whom 72 were diagnosed with PCOS and 96 served as controls. According to BMI, participants were classified as underweight (n = 20), normal weight (n = 73), overweight (n = 22), and obese (n = 53). Serum spexin and phoenixin concentrations were measured using enzyme-linked immunosorbent assay (ELISA). All blood samples were collected under fasting conditions. Perceived stress was assessed using the Bulgarian adaptation of the 14-item Perceived Stress Scale (PSS-14), with total scores calculated according to the adapted 1-5 scoring procedure. Group differences were analyzed using independent-samples t-tests and one-way ANOVA, while associations between variables were evaluated using Spearman correlation analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Spexin levels showed a non-significant trend toward lower values in women with PMOS compared to controls (203.75 ± 226.06 vs. 260.90 ± 240.20), although the difference was not statistically significant (p = 0.120). A moderate positive correlation was found between spexin and phoenixin (r = 0.589, p &lt; 0.001). Spexin demonstrated a weak negative correlation with BMI (r = - 0.135, p = 0.040). PSS scores ","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435268","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":"Coexistence of VLCAD deficiency and Hashimoto's thyroiditis: a rare case report.","authors":"Yasemin Emur Gunay, Gokhan Aydın, Ahmet Cumhur Dulger","doi":"10.1186/s12902-026-02364-1","DOIUrl":"10.1186/s12902-026-02364-1","url":null,"abstract":"<p><strong>Background: </strong>Very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency is a mitochondrial fatty acid oxidation disorder caused by mutations in the acyl-CoA dehydrogenase very long chain (ACADVL) gene. Hashimoto's thyroiditis is the most common autoimmune thyroid disease. To the best of our knowledge, their coexistence has not been reported. This case highlights a potential mechanistic link between mitochondrial dysfunction, chronic inflammation, and endocrine autoimmunity.</p><p><strong>Case presentation: </strong>A 33-year-old woman presented with acute-onset generalized myalgia, fatigue, and dark-colored urine. Laboratory findings confirmed severe rhabdomyolysis. Thyroid tests revealed primary hypothyroidism with elevated anti-TPO and anti-Tg levels, and ultrasonography demonstrated chronic autoimmune thyroiditis. The patient had a history of recurrent unexplained rhabdomyolysis without identifiable external triggers. Therefore, genetic testing was performed to evaluate for an underlying metabolic myopathy. Genetic testing identified a homozygous ACADVL c.1097G>A (p. Arg366His) variant, confirming VLCAD deficiency. Treatment included intravenous hydration, L-carnitine supplementation, a medium-chain triglyceride (MCT)-enriched diet, and levothyroxine. The patient showed marked improvement and remained stable without recurrence for one year.</p><p><strong>Conclusions: </strong>To the best of our knowledge, this appears to be the first report describing the coexistence of VLCAD deficiency and Hashimoto's thyroiditis. Chronic mitochondrial dysfunction may potentially contribute to systemic inflammation and immune activation associated with autoimmune thyroid disease. Increased awareness of this association may facilitate earlier clinical recognition and encourage comprehensive evaluation.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148435208","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 body composition and bone mineral density in young and middle-aged adults.","authors":"Qi Yanmeng, Zhou Xiaoyu, Wang Xiao, Shang Xuesong, Chen Anqi, Jiao Xitong, Han Xueyan, Li Yan","doi":"10.1186/s12902-026-02414-8","DOIUrl":"10.1186/s12902-026-02414-8","url":null,"abstract":"&lt;p&gt;&lt;p&gt;In this cross-sectional study, we aimed to explore the correlation between body composition and bone mineral density (BMD) in young and middle-aged people with different gender and different BMI groups. We selected 1,295 young and middle-aged people (20 to 50 years old) who underwent physical examination at the Health Management Center of the International Medical Service (Xidan Branch) of Peking Union Medical College Hospital from January 2020 to June 2024 as the study subjects, and demographic characteristics, laboratory examinations, body composition(assessed by bioelectrical impedance analysis, including measurements of skeletal muscle mass, skeletal muscle index, body fat mass, percent body fat, fat-free mass, and visceral Fat Area), and dual-energy X-ray bone absorptiometry (DXA) results were collected. Based on gender and body mass index (BMI), the study participants were categorized into three groups: normal weight (18.5 kg/m² ≤ BMI &lt; 24 kg/m²), overweight (24 kg/m² ≤ BMI &lt; 28 kg/m²), and obese (BMI ≥ 28 kg/m²). One-way ANOVA was employed to assess differences among the three groups. The relationship between BMI and BMD was analyzed using multiple regression models along with natural cubic spline models. Additionally, multiple regression models were used to examine the association between body composition and BMD. There were 774 males (216 in the normal body composition group, 380 in the overweight group, and 178 in the obese group) and 521 females (386 in the normal body composition group, 99 in the overweight group, and 36 in the obese group), and there was a significant difference in the laboratory results, body composition, and BMD among the three groups of males and females (all P &lt; 0.05). Multiple regression analysis, after adjusting for age, smoking and alcohol consumption history, hypertension, and diabetes mellitus, revealed a significant positive correlation between BMI and BMD at all skeletal sites (all P &lt; 0.05). The obese group exhibited a more pronounced increase in BMD compared to the overweight group (lumbar spine BMD: β = 0.04, 95% CI 0.02-0.07; femoral neck BMD: β = 0.09, 95% CI 0.07-0.11; total hip BMD: β = 0.11, 95% CI 0.09-0.13; all P &lt; 0.05). Further analysis of the nonlinear relationship between BMI and BMD demonstrated that in women, BMD at all sites increased with higher BMI. In contrast, men exhibited an inverted U-shaped nonlinear association, with a decline in BMD observed in the high BMI range (BMI ≥ 30 kg/m²). The correlation between body composition and BMD, skeletal muscle mass (SMM), skeletal muscle index (SMI), and fat free mass (FFM) were significantly positively correlated with BMD at all sites in both males and females (P &lt; 0.05), and percent body fat (PBF) was negatively correlated with BMD at all sites in the obese group of males, the overweight groups of males and females (P &lt; 0.05). Among young and middle-aged individuals, men show a decline in BMD when BMI reaches 30 or above, whereas women ","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418817","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":"Deep learning-based classification of gh-secreting pituitary neuroendocrine tumors granulation patterns using H&E-stained histopathology.","authors":"Zeming Yan, Yi Lin, Qingjun Cen, Wanming Hu, Zongming Wang, Zize Feng, Jing Guo, Xiaobing Jiang","doi":"10.1186/s12902-026-02393-w","DOIUrl":"10.1186/s12902-026-02393-w","url":null,"abstract":"<p><p>Accurate classification of granulation patterns in growth hormone-secreting pituitary neuroendocrine tumors (GH-PitNETs) is clinically essential but traditionally dependent on labor-intensive immunohistochemistry (IHC). To address this, we developed the Cross-Attention Pituitary Neuroendocrine Tumor Network (CA-PITNET), a deep learning model for automated subtyping directly from routine H&E-stained whole-slide images (WSIs). Utilizing 95 GH-PitNETs WSIs (54,610 patches) and 36 nonfunctioning PitNET WSIs (39,590 patches), the model was evaluated on two tasks: distinguishing GH-PitNETs from nonfunctioning PitNETs (Task I) and differentiating densely from sparsely granulated GH-PitNETs (Task II). Following staining normalization and rigorous validation, CA-PITNET demonstrated exceptional diagnostic accuracy. For Task I, CA-PITNET achieved patient-level AUCs of 0.948 (95% CI: 0.854-1.000; internal validation, n = 48) and 0.948 (95% CI: 0.837-1.000; external test, n = 33), with accuracy of 0.938 and 0.909, respectively. For Task II, patient-level AUCs were 0.935 (95% CI: 0.890-1.000; internal validation, n = 38) and 0.875 (95% CI: 0.670-1.000; external test, n = 25), with accuracy of 0.895 and 0.840, respectively. Generated heatmaps precisely localized diagnostic regions, highlighting diagnostically relevant regions consistent with pathologist-reviewed areas. This model is designed to augment the pathological workflow by improving the subtyping efficiency of GH-PitNETs, serving as a valuable adjunct to the standard IHC-based classification.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418598","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 the triglyceride-glucose index and urinary albumin-to-creatinine ratio in patients with early-onset type 2 diabetes.","authors":"Wei Wang, Wenjing Dong, Shiju Yan, Di Sun, Lingyun Song, Zhe Xue, Ying Zhou, Qiaoling Chen, Ping Pang","doi":"10.1186/s12902-026-02411-x","DOIUrl":"10.1186/s12902-026-02411-x","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Patients with early-onset type 2 diabetes mellitus (T2DM) face a significantly elevated risk of developing diabetic kidney disease (DKD) in the early stages, attributable to their prolonged disease duration. The urinary albumin-to-creatinine ratio (UACR) serves as a critical marker for screening incipient renal injury. While insulin resistance (IR) is a pivotal driver of this pathological progression, the triglyceride-glucose (TyG) index, a simple and effective surrogate marker for IR, has not been thoroughly investigated in this specific population. The association between TyG index and UACR, along with its potential discriminatory ability for early renal damage in patients with early-onset T2DM, remained unclear.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to explore the correlation between the TyG index and UACR in patients with early-onset type 2 diabetes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research design and methods: &lt;/strong&gt;A dual-center, retrospective cross-sectional study was conducted. Clinical data from a total of 596 adult patients (aged 18-40 years) with early-onset type 2 diabetes mellitus, admitted to the First Medical Center of the Chinese PLA General Hospital and Hainan Hospital of the Chinese PLA General Hospital between January 2012 and December 2022, were collected and retrospectively analyzed. Participants were stratified into three groups based on the tertiles of the TyG index: Q1 (&lt; 7.67), Q2 (7.67-8.33), and Q3 (&gt; 8.33). They were also categorized into two groups according to UACR levels: &lt;30 mg/g and ≥ 30 mg/g. The association between TyG index, traditional glucose/lipid parameters, and elevated UACR (≥ 30 mg/g) was assessed using correlation analysis and binary logistic regression models. Receiver operating characteristic (ROC) curves were plotted to evaluate the discriminatory ability of these indicators for elevated UACR. Subgroup analyses were further performed based on gender, blood pressure status, and estimated glomerular filtration rate (eGFR).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean age of the 596 participants was 31.78 ± 9.99 years. A significant positive correlation was observed between the TyG index and UACR (r = 0.250, P &lt; 0.001). Binary logistic regression analysis revealed that after adjustment for multiple confounding factors, patients in the highest TyG tertile (Q3) had a 1.366-fold increased risk of elevated UACR (≥ 30 mg/g) compared to those in the lowest tertile (Q1) (OR: 1.366, 95% CI: 1.015-1.838, P = 0.039). The discriminatory ability of TyG index for elevated UACR was evaluated using the receiver operating characteristic curve, yielding an area under the curve of 0.649 (95% CI: 0.609-0.687). At the optimal cut-off value of 8.18, the sensitivity and specificity were 69.47% and 61.08%, respectively. Notably, the TyG index demonstrated superior discriminatory efficacy compared to traditional lipid parameters, including triglycerides, total cholesterol, LDL-C, and HDL-C.&lt;/p&gt;&lt;p&gt;&lt;stro","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418867","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":"Novel phenotypic clusters of adult-onset diabetic kidney disease based on static and dynamic clustering algorithms - a data-driven multi-center study.","authors":"Kun Li, Lingling Wei, Ruili Yin, Miao Xu, Qiubo Zhao, Jing Ke, Longyan Yang","doi":"10.1186/s12902-026-02412-w","DOIUrl":"10.1186/s12902-026-02412-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify clinically interpretable DKD sub-phenotypes for personalized prognosis and intervention.</p><p><strong>Methods: </strong>We enrolled participants with type 2 diabetes mellitus (T2DM) from three hospitals in China. Clinically interpretable sub-phenotypes were identified using two complementary clustering frameworks: a static model (k-means clustering) capturing the metabolic-renal profile at DKD diagnosis, and a dynamic model (group-based multi-trajectory model, GBMTM) reconstructing longitudinal trajectories preceding diagnosis. Associations between DKD clusters and post-diagnosis DKD progression were estimated using cox regression.</p><p><strong>Results: </strong>A total of 1520 participants were included for the analysis of static clustering, 32.53% were females with a mean age of 54.4 ± 12.1 years. The static clustering method classified DKD patients into four clusters: BALANCE, YOUTH, TYPICAL and NATURAL. Compared with the participants in YOUTH, the hazard ratios (HRs) of progressing to higher stage of CKD (G3b-G5) in BALANCE, TYPICAL and NATURAL are 1.68 (95%CI:0.81-3.49), 7.85 (95%CI:4.25-14.51), 6.58 (95%CI:3.54-12.24), respectively. GBMTM identified three longitudinal trajectories. The HRs (95%CI) of progressing to higher stage of CKD (G3b-G5) was 2.48 (95%CI:1.50-4.09) in Trajectory 1 compared with Trajectory 2. In addition, the clustering results obtained from the validation cohort were consistent with the derivation cohort.</p><p><strong>Conclusions: </strong>By integrating static and dynamic clustering approaches, this study identifies novel DKD sub-phenotypes, and evaluated the risk of DKD progression in each cluster.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418633","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}