BMC Endocrine Disorders最新文献

{"title":"HbA1c measurement using capillary blood in epidemiological studies: a scoping review of technologies and approaches.","authors":"Bruna Suellen Breternitz, Raquel Queiroz de Araújo, Edna Terezinha Rother, Alice Barone de Andrade, Paula Carvalho de Freitas, Luiz Menezes-Júnior, Oscar Geovanni Enriquez-Martinez, Leticia de Oliveira Cardoso, Michele Lacerda Ferrer, Etienne Duim","doi":"10.1186/s12902-026-02410-y","DOIUrl":"10.1186/s12902-026-02410-y","url":null,"abstract":"<p><strong>Objective: </strong>To map and describe the capillary blood-based technologies employed to measure glycated hemoglobin (HbA1c) in epidemiological studies, focusing on their accuracy, applicability, feasibility, and implementation barriers.</p><p><strong>Introduction: </strong>The development of technologies for diabetes screening and monitoring has expanded, particularly in decentralized and epidemiological contexts.</p><p><strong>Methods: </strong>A scoping review was conducted in accordance with PRISMA-ScR guidelines. A comprehensive literature search was performed in Embase, Scopus, Web of Science, LILACS, and CINAHL between 18 and 24 February 2025. The search was conducted without restrictions on language, publication year, or geographic location, retrieving studies indexed up to 31 January 2025. We included primary epidemiological studies involving adults (≥ 18 years) that assessed HbA1c measurement using capillary blood technologies or approaches in field or population-based settings. Studies exclusively evaluating capillary glucometers, continuous glucose monitoring, or oral glucose tolerance tests were excluded. Two reviewers independently screened records and assessed full-text eligibility against pre-specified criteria registered on the Open Science Framework (OSF). Data were extracted and synthesized descriptively based on outcomes reported by the original study authors and categorized in regard to the aim.</p><p><strong>Results: </strong>Of 2,238 records screened, 106 studies were included. Fifteen distinct analytical technologies for HbA1c measurement using capillary blood were identified, with Point-of-Care Testing (PoCT) devices representing the predominant category. Among studies reporting diagnostic accuracy metrics, sensitivity ranged from 17.4% to 100% and specificity from 43.5% to 99.1%. PoCT devices required 2-10 µL of capillary blood and produced results within minutes. Applicability findings described portability, limited training requirements, and use in decentralized settings. Dried Blood Spot (DBS) approaches facilitated remote collection and mailing to reference laboratories. Reported challenges included variability in analytical performance, limited validation in Low- and Middle-Income Countries (LMICs), and operational constraints related to cost, supply logistics, and integration into health systems. Overall, 77% of included studies were conducted in High-Income Countries (HICs).</p><p><strong>Conclusions: </strong>Capillary blood-based technologies for HbA1c measurement have been applied across diverse epidemiological contexts, with reported analytical and operational characteristics consistent with decentralized use. Nevertheless, the evidence remains geographically concentrated and heterogeneous, indicating gaps in research from LMICs.</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/PMC13644120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418674","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":"Threshold effect of the METS-VF index on hyperuricemia in adults with hypertension: a cross-sectional study.","authors":"Meihui Wu, Congcong Yan, Shiping Li, Lingjuan Zhu, Chao Yu, Tao Wang, Wei Zhou, Weifang Zhang, Huihui Bao, Xiaoshu Cheng","doi":"10.1186/s12902-026-02415-7","DOIUrl":"10.1186/s12902-026-02415-7","url":null,"abstract":"<p><strong>Background: </strong>Hyperuricemia (HUA) is a major public health concern that is closely linked to obesity. The novel visceral adiposity index (METS-VF) demonstrates significant associations with multiple chronic diseases, yet its association with HUA risk in hypertensive patients remains unclear. This study aimed to investigate this association in a Chinese hypertensive population.</p><p><strong>Methods: </strong>This study utilized data from the Chinese Hypertension Registry Study, including 13,341 hypertensive patients. Data collection was conducted through standardized questionnaires, physical examinations, and laboratory tests. We evaluated the association between METS-VF and HUA using multivariate logistic regression models. Robustness was assessed via multivariable-adjusted models and subgroup analyses.</p><p><strong>Results: </strong>The overall prevalence of HUA was 55.3%. Each unit increase in METS-VF was associated with a 8.48 (95% CI: 6.64, 10.32) µmol/L increase in serum uric acid levels and a 25% higher risk of HUA (OR = 1.25; 95% CI: 1.20, 1.30). HUA risk increased significantly across increasing METS-VF quartiles (P for trend < 0.001). Further analysis revealed a non-linear, threshold relationship. Subgroup analysis indicated a stronger association in women (P for interaction < 0.001).</p><p><strong>Conclusion: </strong>In patients with hypertension, the visceral adiposity index (METS-VF) was positively associated with the risk of hyperuricemia (HUA).</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/PMC13644014/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418614","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":"Multidimensional associations of HbA1c with behavioural, psychosocial, and economic factors across Educational Pharmaceutical Care Interventional Program (EPCIP) timeline: a prospective, longitudinal, RCT study.","authors":"Rishita Darshan Patel, Harshaben Vishnubhai Patel, Alpa Gor","doi":"10.1186/s12902-026-02379-8","DOIUrl":"https://doi.org/10.1186/s12902-026-02379-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;According to real-time data from Gujarat, which has the third highest score in the country nationally (7.55%), shows that behavioral, psychological, and economic stressors are associated with elevating HbA1c levels. The current investigation of multifaceted connection within the educational pharmaceutical care interventional program (EPCIP) timeline provides important information about regional causes of inadequate glycaemic control and aids in the development of tailored diabetes management strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The primary objective of this study was to examine the association between longitudinal variations in HbA1c and a structured hospital-based EPCIP delivered by clinical pharmacists. In addition, secondary objective was focused on behavioral, medication adherence, psychological, and economic characteristics of patients in the control group (n = 139) and intervention group (n = 141) across five visits conducted in Gujarat, India.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methodology: &lt;/strong&gt;A randomized, parallel‑group trial was conducted at the Saarathi Institute of Diabetes Sciences, Anand, India, enrolling 280 patients with type 2 diabetes mellitus aged 18-75 years. Eligible participants (HbA1c &gt; 7%, on oral hypoglycemic agents and/or insulin therapy) were recruited and allocated into control (n = 139) and intervention (n = 141) groups using adaptive randomization minimization. The intervention comprised a structured patient‑education framework focusing on self‑management and adherence. Over a 16‑month period (64 weeks), patients in the intervention group attended one educational and one discussion session at each follow‑up (0, 4, 8, 12, and 16 months). Associations between HbA1c and behavioral outcomes (Knowledge, Attitude, Practice [KAP] questionnaire), adherence (Morisky Medication Adherence Scale [MMAS‑8]), psychosocial outcomes (Diabetes Distress Scale [DDS‑17], WHOQOL‑BREF), and economic outcomes (Cost of Illness Questionnaire [COIQ]) were analyzed using regression models to estimate linear relationships across visits between groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The EPCIP intervention group showed progressively stronger longitudinal correlations in HbA1c stability (r = 0.74 to 0.89, p=0.000), surpassing the control group (r = 0.62 to 0.74). At Visit 5, significant correlations were observed between HbA1c and indirect cost (r = 0.160, p = 0.022), and medication adherence (MMAS: r = -0.243, p = &lt; 0.001). Total KAP scores maintained consistent negative correlations (r = -0.042, p=0.030), while emotional (r = 0.141, p = 0.044) and physician-related distress (r = 0.593, p &lt; 0.001) notably decreased. Regimen distress normalized (r = -0.019, p = 0.792). Quality of life scores improved post-intervention across physical (r = -0.078, p = 0.006), psychological (r = -0.033, p = 0.047), social (r = -0.047, p = 0.005), and environmental domains (r = -0.113, p = 0.001), indicating EPCIP's multidimensional impact","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive models of adverse outcomes of overweight or obesity: a nationwide cohort validation.","authors":"Alexander Turchin, Maria Shubina, Fritha J Morrison, Nadia N Ahmad, Lisa M Neff, Hong Kan","doi":"10.1186/s12902-026-02399-4","DOIUrl":"10.1186/s12902-026-02399-4","url":null,"abstract":"<p><strong>Background: </strong>Obesity and overweight have a wide range of adverse clinical outcomes. Predictive models could help clinicians identify individuals with obesity and overweight at greater risk for obesity-related complications, enabling personalized shared decision-making about obesity treatment. We previously developed a set of predictive models of adverse clinical outcomes of obesity and overweight using electronic health record (EHR) data of a large health system in Massachusetts. However, these models have not been validated on data from other sources.</p><p><strong>Methods: </strong>We validated 12 predictive models for cardiometabolic, oncologic and musculoskeletal complications of excess weight using a linked EHR and claims dataset of a national patient cohort (Optum^® Market Clarity) that included adults 18-80 years of age with body mass index (BMI) ≥ 25 kg/m² between 2007 and 2023.</p><p><strong>Results: </strong>A 5% randomly selected validation dataset included 437,223 patients (51.9% women) with a mean age of 51.4 years and a mean BMI of 31.9 kg/m² who were followed for a mean of 5.7 years. Most (11/12) models achieved Harrell C-index ≥ 0.70. Most (11/12) models had either 5-year or 10-year calibration slope within 0.3 of the ideal value of 1.0; 7 out of 12 had either 5-year or 10-year calibration slope that was not significantly different from 1.0; all had intercepts very close to 0.</p><p><strong>Conclusions: </strong>A set of EHR-based predictive models of adverse outcomes of obesity and overweight was generalizable to a large national cohort. These findings suggest potential clinical and population health applications for predictive models in treatment of individual patients with obesity / overweight, as well as in population management and quality improvement.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13556077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418677","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 diabetic ketoacidosis burden and precipitant patterns in established type 1 diabetes using continuous subcutaneous insulin infusion versus multiple daily injections: an 11-year retrospective single-center study.","authors":"Ruixia Liu, Tianrong Pan","doi":"10.1186/s12902-026-02419-3","DOIUrl":"10.1186/s12902-026-02419-3","url":null,"abstract":"<p><strong>Background: </strong>Diabetic ketoacidosis (DKA) remains a major acute complication in people with established type 1 diabetes, but whether recurrent DKA burden and precipitant patterns differ by insulin-delivery modality is not well defined. We compared recurrent DKA burden and precipitant patterns between continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI), and evaluated severity and short-term outcomes of index eligible admissions.</p><p><strong>Methods: </strong>We retrospectively screened DKA hospitalizations in patients with type 1 diabetes between 2014 and 2024. Admissions at initial type 1 diabetes diagnosis, those involving preadmission insulin regimens other than CSII or basal-bolus MDI, and records insufficient to assess key variables or outcomes were excluded. Index-admission analyses used treatment modality at the earliest eligible hospitalization (CSII, n = 33; MDI, n = 95). Patient-level recurrence analyses used predominant modality across eligible hospitalizations (CSII, n = 35; MDI, n = 93). Recurrent DKA was defined as at least two eligible admissions. Logistic regression was used for adjusted analyses.</p><p><strong>Results: </strong>The cohort comprised 180 eligible DKA hospitalizations in 128 patients. Recurrent admissions accounted for 52/180 hospitalizations (28.9%), and 30/128 patients (23.4%) experienced recurrent DKA. In the primary patient-level analysis, recurrent DKA was more frequent in CSII than in MDI (13/35 [37.1%] vs. 17/93 [18.3%]); the adjusted odds ratio was 2.64 (95% confidence interval 1.07-6.55; P = 0.036). In index admissions, hospital stay was shorter in CSII than in MDI (7.0 [5.0, 9.0] vs. 9.0 [7.0, 11.0] days; P = 0.006). Among adults, CSII was independently associated with lower odds of severe DKA (adjusted odds ratio 0.30, 95% confidence interval 0.11-0.77; P = 0.012). Recorded precipitating factors were summarized descriptively. Among recurrent CSII admissions, device/infusion-related failure was recorded in 7/30 admissions (23.3%); among recurrent MDI admissions, infection/intercurrent illness and insulin omission/insufficiency were recorded in 10/22 (45.5%) and 6/22 (27.3%) admissions, respectively.</p><p><strong>Conclusions: </strong>Among patients with established type 1 diabetes who had experienced at least one DKA hospitalization, recurrent DKA was common. Recurrence was more frequent among patients classified as CSII users in the primary analysis, although the strength and statistical significance of this association varied across sensitivity analyses. Recorded precipitating factors suggested treatment-specific clinical contexts and should be interpreted descriptively.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418698","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":"Factors influencing the optimal glycemic levels in type 2 diabetes mellitus patients attending the diabetic clinic of a tertiary care hospital in New Delhi.","authors":"Ishant Kumar, Sanjeet Panesar, Rishi Kumar Jaiswal, Neelam Roy, Deepak Dhamnetiya","doi":"10.1186/s12902-026-02417-5","DOIUrl":"10.1186/s12902-026-02417-5","url":null,"abstract":"<p><strong>Background: </strong>Optimal glycaemic control is essential for preventing complications of type 2 diabetes mellitus (T2DM), yet a large proportion of patients fail to achieve recommended glycaemic targets even in tertiary care settings. Identifying independent behavioural and treatment-related determinants of glycaemic control is crucial for improving diabetes management.</p><p><strong>Methods: </strong>A hospital-based analytical cross-sectional study was conducted among 416 adult patients with T2DM attending the diabetic outpatient department of a tertiary care hospital. Data were collected using a structured, pre-tested questionnaire covering sociodemographic profile, lifestyle practices, treatment adherence, and healthcare access. Glycaemic control was assessed using HbA1c values and categorized as optimal (< 7%) and poor (≥ 7%). Descriptive statistics, chi-square test, Spearman correlation, and multivariable logistic regression were applied using IBM SPSS Statistics for Mac (Version 31.0).</p><p><strong>Results: </strong>Optimal glycaemic control was observed in 239 (57.5%) participants, while 177 (42.5%) had poor control. Higher physical activity, adherence to a diabetic diet, and consistent medication adherence were significantly associated with optimal glycaemic control in bivariate analysis (p < 0.05). Spearman correlation showed a strong positive correlation between medication adherence and glycaemic control, followed by physical activity and regular follow-up. In multivariable regression analysis, medication adherence, physical activity, and regular follow-up emerged as significant independent predictors of optimal glycaemic control, whereas sociodemographic factors showed weaker adjusted effects.</p><p><strong>Conclusion: </strong>Glycaemic control among patients with T2DM is predominantly influenced by modifiable behavioural and treatment-related factors. Strengthening medication adherence counselling, lifestyle modification, and structured follow-up within tertiary care diabetes clinics may substantially improve glycaemic outcomes and reduce the long-term burden of diabetes-related complications.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418671","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":"Real-world management of hypoparathyroidism: the impact of endocrinology specialist follow-up on biochemical and clinical outcomes - a retrospective cohort study.","authors":"Sezin Doğan Çakır, Mine Adaş","doi":"10.1186/s12902-026-02400-0","DOIUrl":"10.1186/s12902-026-02400-0","url":null,"abstract":"<p><strong>Background: </strong>Hypoparathyroidism is a chronic endocrine disorder requiring lifelong management, with real-world data on the impact of follow-up setting on biochemical and clinical outcomes remaining limited. This study aimed to evaluate real-world management of hypoparathyroidism and to investigate whether endocrinology specialist follow-up is associated with improved biochemical control and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective, single-center study included 186 patients with hypoparathyroidism categorized by follow-up setting (endocrinology vs. non-endocrinology clinics). Demographic, biochemical, and clinical data were collected. The primary outcome was achievement of target serum calcium levels (lower-normal or slightly below-normal range per current guidelines). Multivariate logistic regression was performed to identify independent predictors of target calcium achievement, adjusted for age, sex, eGFR, PTH, treatment doses, and serum 25(OH)D.</p><p><strong>Results: </strong>The mean age of the cohort was 49.5 ± 12.0 years, 78.5% were female and 82.3% had postsurgical hypoparathyroidism. Overall, 76.3% of patients achieved target serum calcium levels; while target phosphate and 25(OH)D levels were achieved in only 45.2% and 46.9%, respectively.Patients followed by endocrinology specialists demonstrated significantly higher rates of target calcium (96.3% vs. 60.6%, p<0.001), phosphate (53.7% vs. 38.5%, p=0.039), and 25(OH)D achievement (57.3% vs. 29.2%, p=0.002) compared with those followed in non-endocrinology settings. Daily calcium supplementation and calcitriol doses were comparable between groups. Guideline-recommended monitoring, including 24-hour urinary calcium and serum 25(OH)D assessment, as well as complication screening, was performed significantly more frequently in the endocrinology group (all p<0.001). In multivariate analysis, non-endocrinology follow-up was independently associated with lower odds of target calcium achievement (OR: 0.08, 95% CI: 0.02-0.33, p<0.001), while serum 25(OH) D was a positive predictor of target calcium achievement (OR: 1.12, 95% CI: 1.01-1.23, p=0.030). The model demonstrated adequate goodness-of-fit (Hosmer-Lemeshow p=0.127).</p><p><strong>Conclusions: </strong>Follow-up by endocrinology specialists is independently associated with improved biochemical control in patients with hypoparathyroidism, an effect not explained by differences in medication doses. These findings suggest that specialist follow-up may play an important role in optimizing biochemical target achievement and long-term disease management and support the integration of endocrinology specialist care as a standard component of routine clinical practice in hypoparathyroidism.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418622","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":"Liddle syndrome caused by SCNN1B mutation presenting with severe early-onset hypertension and hypokalemia in an adolescent: a case report.","authors":"Xiao Min, Yuan Liang","doi":"10.1186/s12902-026-02407-7","DOIUrl":"10.1186/s12902-026-02407-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Liddle syndrome is a rare autosomal dominant form of monogenic hypertension caused by gain-of-function mutations in genes encoding the epithelial sodium channel (ENaC). The disease is characterized by early-onset hypertension, hypokalemia, metabolic alkalosis, and suppression of the renin-angiotensin-aldosterone system (RAAS). Early diagnosis is essential because targeted therapy with ENaC inhibitors can effectively control blood pressure and prevent end-organ damage, whereas mineralocorticoid receptor antagonists are ineffective.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;We report a 15-year-old Chinese male who presented with severe hypertension (196/143 mmHg) and profound hypokalemia (1.73 mmol/L) with a history of hypertension since the age of 10 years. Laboratory evaluation revealed suppressed plasma renin concentration (3.157 pg/mL), relatively normal aldosterone (61.784 pg/mL), and an aldosterone-to-renin ratio of 19.57. Arterial blood gas analysis demonstrated metabolic alkalosis (pH 7.48, HCO₃⁻ 28 mmol/L). A 24-hour urinary potassium excretion of 81.65 mmol/day confirmed renal potassium wasting. Serum cortisol and ACTH were within normal limits. Although definitive biochemical exclusion of apparent mineralocorticoid excess (AME) and glucocorticoid-remediable aldosteronism (GRA) was not performed, no pathogenic variants were identified in HSD11B2, CYP11B1, or CYP11B2 on the comprehensive genetic panel, providing molecular-level exclusion of these conditions. Echocardiography demonstrated ventricular wall thickening with mild valvular regurgitation. Brain MRI revealed bilateral basal ganglia and left corona radiata encephalomalacia with white-matter hyperintensity (Fazekas grade 1), indicating chronic hypertensive brain injury. Next-generation sequencing identified a heterozygous SCNN1B variant (NM_000336.3: c.1853 C &gt; G; p.Pro618Arg; absent from gnomAD), classified as Likely Pathogenic per ACMG/AMP guidelines (criteria: PM1, PM2, PP3, PP4), confirming the diagnosis of Liddle syndrome. Treatment with compound amiloride tablets and potassium supplementation normalized serum potassium within 48 h and significantly improved blood pressure. At one-month follow-up, blood pressure was well controlled at 130/80 mmHg. Long-term follow-up is ongoing to assess sustained blood pressure control and end-organ recovery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Although SCNN1B p.Pro618Arg is a recognized pathogenic hotspot variant, this case highlights the severe phenotypic consequences of delayed diagnosis in adolescents, and demonstrates that early genetic diagnosis and targeted ENaC inhibitor therapy are achievable even in resource-limited rural clinical settings. Early recognition and targeted therapy with ENaC inhibitors are critical to prevent serious cardiovascular and cerebrovascular complications. Genetic testing is essential for definitive diagnosis, particularly in resource-limited settings where misdiagnosis as primar","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13637182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148418689","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":"Clinical significance of coexisting Hashimoto's thyroiditis in differentiated thyroid cancer: a retrospective cohort study.","authors":"Syed Haseeb Zia, Li Ying, Zhang Wenwen, Liu Jiazheng, Alveena Nasim Khan, Muhammad Shahbaz Raja, Hamza Maqbool, Liu Zhao","doi":"10.1186/s12902-026-02404-w","DOIUrl":"10.1186/s12902-026-02404-w","url":null,"abstract":"<p><strong>Background: </strong>The association between Hashimoto's Thyroiditis (HT) and the clinicopathological behavior of Differentiated Thyroid Cancer (DTC) remains controversial. In particular, whether coexisting autoimmune thyroiditis independently influences invasive tumor characteristics after adjustment for tumor-related factors remains unclear. This study aimed to evaluate the relationship between HT and clinicopathological features of DTC, with a focus on tumor size, lymph node metastasis, and pathological indicators of tumor aggressiveness.</p><p><strong>Methods: </strong>This retrospective observational study included 198 patients with histologically confirmed DTC who underwent thyroidectomy between June 2023 and March 2025. Patients were stratified according to the presence or absence of Hashimoto's Thyroiditis. Tumor size, lymph node metastasis, capsular invasion, and extrathyroidal extension were compared between groups. Tumor aggressiveness was defined as capsular invasion and/or extrathyroidal extension. Multivariate logistic regression analysis was performed to assess independent associations. Model performance was evaluated using receiver operating characteristic (ROC) analysis and nomogram visualization.</p><p><strong>Results: </strong>Patients with coexisting HT presented with significantly smaller tumors compared with those without HT (median tumor size: 9 mm vs. 12 mm; p = 0.003). Lymph node metastasis was observed less frequently in the HT group than in the non-HT group (4.1% vs. 46.8%; p < 0.001). In multivariate analysis, tumor size was independently associated with tumor aggressiveness (odds ratio [OR] = 1.49, 95% confidence interval [CI]: 1.11-1.99; p = 0.008), whereas HT was not independently associated with aggressive pathological features (OR = 1.10, 95% CI: 0.70-1.73; p = 0.692). The predictive model demonstrated limited discriminative ability (AUC = 0.587), although calibration was acceptable.</p><p><strong>Conclusions: </strong>Hashimoto's Thyroiditis is associated with smaller tumor size and a lower prevalence of lymph node metastasis in patients with Differentiated Thyroid Cancer. However, HT is not an independent predictor of pathological tumor aggressiveness after adjustment for tumor size. These findings suggest that HT may influence disease presentation but should not be considered a standalone prognostic factor for invasive tumor behavior.</p><p><strong>Trial registration: </strong>Not applicable. This study was a retrospective observational cohort study and did not involve prospective clinical trial registration.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of probiotic and synbiotic supplementation on metabolic and endocrine parameters in polycystic ovary syndrome: a meta-analysis of randomized controlled trials.","authors":"Zhuangzhuang Sun, Ru Zhang, Xiao Tian, Ting Li, Zhenkun Liu","doi":"10.1186/s12902-026-02398-5","DOIUrl":"10.1186/s12902-026-02398-5","url":null,"abstract":"<p><strong>Background: </strong>This systematic review and meta-analysis aimed to evaluate the effects of probiotic and synbiotic supplementation on insulin resistance, reproductive endocrine function, lipid metabolism, inflammatory response, anthropometric parameters, and oxidative stress in patients with polycystic ovary syndrome (PCOS).</p><p><strong>Methods: </strong>Databases including PubMed, Web of Science, the Cochrane Library and Embase were systematically searched from inception to March 19, 2026. The Cochrane Risk of Bias Assessment Tool (RoB 2.0) was used for study quality evaluation. Meta-analysis was conducted with RevMan 5.4 and Stata 17.0. The study was prospectively registered in PROSPERO (CRD420251125178) and reported following PRISMA guidelines.</p><p><strong>Results: </strong>Eleven randomized controlled trials involving 780 participants were included. Probiotic and synbiotic supplementation significantly reduced fasting insulin (MD = - 1.41, 95% CI: -2.76 to - 0.05), total testosterone (MD = - 0.19, 95% CI: -0.25 to - 0.12), triglycerides (MD = - 12.28, 95% CI: -24.21 to - 0.35), low-density lipoprotein cholesterol (MD = - 6.19, 95% CI: -10.08 to - 2.30), BMI (MD = - 0.49, 95% CI: -0.88 to - 0.10), and body weight (MD = - 1.07, 95% CI: -2.08 to - 0.05), while increasing high-density lipoprotein cholesterol (MD = 1.73, 95% CI: 0.40 to 3.06) and total antioxidant capacity (MD = 124.02, 95% CI: 40.49 to 207.54). No significant effects were observed for fasting glucose, HOMA-IR, QUICKI, FSH, LH, SHBG, DHEAS, total cholesterol, C-reactive protein, waist circumference, or hip circumference. The single prebiotic trial contributed only to the meta-analyses of BMI, body weight, and waist circumference. According to the GRADE framework, the certainty of evidence was high for Testosterone, TG, LDL‑C, HDL‑C, BMI, and body weight, moderate for fasting insulin, and low for total antioxidant capacity.</p><p><strong>Conclusion: </strong>Probiotic or synbiotic supplementation significantly improves multiple clinical parameters in women with PCOS, including reductions in fasting insulin, total testosterone, triglycerides, LDL cholesterol, BMI, and body weight, while increasing HDL cholesterol and total antioxidant capacity. However, the effects on fasting blood glucose, HOMA-IR, and certain sex hormones remain unclear and require further validation. The single available prebiotic trial showed benefits only for BMI and body weight, but its evidence is limited.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148410408","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}