BMC Endocrine Disorders最新文献

{"title":"Cardiometabolic and inflammatory profiles associated with intermediate post-DST cortisol levels (1.0-1.8 µg/dL) in patients with adrenal incidentalomas.","authors":"Azad Duman, Murat Alay","doi":"10.1186/s12902-026-02386-9","DOIUrl":"10.1186/s12902-026-02386-9","url":null,"abstract":"<p><strong>Background: </strong>The clinical relevance of post-dexamethasone cortisol levels below the conventional 1.8 µg/dL threshold remains uncertain in patients with adrenal incidentalomas. We aimed to evaluate whether cortisol levels within the 1.0-1.8 µg/dL range are associated with adverse cardiometabolic and inflammatory profiles.</p><p><strong>Methods: </strong>In this retrospective, single-center cohort study, 199 patients with adrenal incidentalomas evaluated between 2023 and 2025 were included. Participants were stratified according to 1 mg overnight dexamethasone suppression test (DST) results into two groups: <1.0 µg/dL (n = 112) and 1.0-1.8 µg/dL (n = 87). Baseline hormonal (ACTH, DHEAS), metabolic (fasting glucose, HbA1c), and hematological parameters were obtained prior to DST to minimize the acute effects of dexamethasone. Systemic inflammation was assessed using the neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII). Group comparisons were performed using appropriate parametric or non-parametric tests. Multivariable logistic regression analysis was conducted to identify independent predictors of hypertension and diabetes mellitus.</p><p><strong>Results: </strong>The prevalences of hypertension (71.3% vs. 42.9%, p < 0.001) and diabetes mellitus (37.9% vs. 18.8%, p = 0.003) were significantly higher in the 1.0-1.8 µg/dL group. These patients exhibited lower basal ACTH (p = 0.012) and DHEAS (p = 0.001) levels, along with higher fasting plasma glucose (p < 0.001) and HbA1c (p = 0.003). Inflammatory markers, including NLR (p = 0.024) and SII (p = 0.040), were also significantly elevated. After adjustment for age, sex, tumor size, and LDL cholesterol, cortisol levels within the 1.0-1.8 µg/dL range remained independently associated with both hypertension (OR = 2.74, 95% CI: 1.35-5.54, p = 0.005) and diabetes mellitus (OR = 2.39, 95% CI: 1.15-4.97, p = 0.020).</p><p><strong>Conclusion: </strong>Cortisol levels between 1.0 and 1.8 µg/dL were associated with increased systemic inflammation and an unfavorable cardiometabolic profile in patients with adrenal incidentalomas. These findings support the concept that cardiometabolic risk may exist along a continuum of post-DST cortisol values, even below the conventional 1.8 µg/dL threshold. Patients within this intermediate cortisol range may benefit from closer clinical follow-up and cardiometabolic risk assessment, although prospective studies are needed to clarify its long-term clinical significance.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350947","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":"Joint association of body roundness index and HOMA-IR with risk of MASLD in Korean populations.","authors":"Kyo-Sun Lee, Sung-Ho Ahn, Da-Hye Son, Yong-Jae Lee","doi":"10.1186/s12902-026-02361-4","DOIUrl":"10.1186/s12902-026-02361-4","url":null,"abstract":"<p><strong>Background: </strong>As the global prevalence of obesity rises, the clinical focus is shifting from simple BMI to a systemic perspective that integrates body composition and metabolic health. This study evaluates the association between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the combined influence of insulin resistance and obesity-related body shape indices.</p><p><strong>Methods: </strong>Utilizing the KoGES cohort (n = 3,196), participants were categorized into four groups based on the median values of HOMA-IR and the Body Roundness Index (BRI). MASLD was defined by an HSI score > 36, at least one metabolic component, and controlled alcohol consumption (< 30 g/day for men, < 20 g/day for women). Cox proportional hazard regression was conducted to assess the risk across groups, including interaction and subgroup analyses to determine the independence of these markers.</p><p><strong>Results: </strong>Both HOMA-IR and BRI were significant predictors of MASLD risk even when fully adjusted, with Hazard Ratios (HR) of 1.80 (95% CI: 1.52-2.12) and 2.33 (95% CI: 1.96-2.76), respectively. In the joint analysis, the group with both high HOMA-IR and high obesity-related body shape index (BRI) showed a 3.58-fold (95% CI: 2.84-4.51) increased risk compared to the reference group. Notably, no significant additive or multiplicative interactions were found, confirming that these two factors serve as independent and distinct predictive markers.</p><p><strong>Conclusions: </strong>Combining HOMA-IR with body shape-related obesity markers like BRI provides a more robust prediction of MASLD risk than individual indices. These findings suggest that integrated monitoring of metabolic and morphological profiles is essential for the early identification of high-risk populations.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338013","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":"Serum uric acid and TG/HDL-C ratio in non-obese working women: an exploratory cross-sectional study.","authors":"Takasuke Asakawa","doi":"10.1186/s12902-026-02380-1","DOIUrl":"10.1186/s12902-026-02380-1","url":null,"abstract":"<p><strong>Background: </strong>Serum uric acid has been suggested to be associated with metabolic abnormalities; however, its independent role remains unclear, particularly among non-obese individuals.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 630 non-obese women (body mass index < 25 kg/m²) selected from an initial cohort of 892 participants. Individuals receiving lipid-lowering therapy and those with missing data on serum uric acid, triglycerides, or HDL-C were excluded. Blood samples included in this analysis were limited to fasting samples obtained as part of routine occupational health examinations. The TG/HDL-C ratio was used as a surrogate marker related to insulin resistance and cardiometabolic risk, rather than as a direct measure of insulin resistance or clinical cardiovascular outcomes. Associations between serum uric acid and the TG/HDL-C ratio were examined using quartile analysis and multivariable linear regression adjusting for age, BMI, systolic blood pressure, medication use, smoking, alcohol consumption, and weight gain since early adulthood.</p><p><strong>Results: </strong>The TG/HDL-C ratio increased across quartiles of serum uric acid, particularly in the upper quartiles. In the crude model, serum uric acid was positively associated with the TG/HDL-C ratio (β = 0.060, p = 0.010), but this association was attenuated after multivariable adjustment and was no longer statistically significant (β = 0.025, p = 0.289). In contrast, BMI (β = 0.063, p < 0.001) and weight gain since early adulthood (β = 0.261, p < 0.001) showed stronger adjusted associations with the TG/HDL-C ratio. Exploratory subgroup analyses were interpreted cautiously because of limited sample size.</p><p><strong>Conclusions: </strong>In this exploratory cross-sectional study, serum uric acid was not independently associated with the TG/HDL-C ratio after adjustment for confounding factors. These findings suggest that serum uric acid may reflect underlying metabolic status in non-obese working women; however, this interpretation should be considered hypothesis-generating because of the cross-sectional design and the use of the TG/HDL-C ratio as a surrogate marker.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350897","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 Fat composition and serum branched chain amino acids in patients with visceral obesity.","authors":"Fatima Gul, Asad Ullah, Yue Li, Zhimin Qian, Ling Cao, Dunmin She, Ying Li","doi":"10.1186/s12902-026-02368-x","DOIUrl":"10.1186/s12902-026-02368-x","url":null,"abstract":"<p><strong>Background: </strong>Obesity, especially visceral obesity, is a major health issue globally, leading to metabolic disorders. Visceral fat accumulation is closely linked to insulin resistance and metabolic abnormalities. The role of branched-chain amino acids (BCAAs, e.g. leucine, isoleucine, and valine) in metabolic health, particularly in visceral obesity, remains unclear. Further investigation is needed to elucidate the relationships among body fat composition, BCAAs, and metabolic dysfunction in visceral obesity.</p><p><strong>Purpose: </strong>This study investigates the correlation between serum BCAAs levels and body fat composition in individuals with visceral obesity, as well as the association between these levels and metabolic indicators.</p><p><strong>Methods: </strong>A total of 105 participants were recruited and categorized into three groups: obesity without type 2 diabetes mellitus (T2DM) (n = 52), obesity with T2DM (n = 32), and healthy controls (n = 21). All participants underwent assessments of anthropometric measurements, biochemical parameters, and serum amino acid profiles. Correlation tests and multiple linear regression models were used to analyze relationships among variables and potential associations.</p><p><strong>Results: </strong>Serum BCAAs levels were significantly higher in both obese groups than in the healthy, normal-weight control group (p < 0.001). Compared with the healthy normal-weight controls, valine showed the greatest increase (obesity non-T2DM: 36.48 ± 8.33 µg/mL; obesity and T2DM: 43.46 ± 7.68 µg/mL; controls: 30.48 ± 4.19 µg/mL). In Pearson's analysis, BCAAs were positively associated with visceral fat area (VFA), body mass index (BMI), waist circumference (WC), body fat ratio, and IR-related markers (HOMA-IR, fasting insulin, and HbA1c) (all p < 0.05). Valine demonstrated the strongest correlations with HOMA-IR (r = 0.481, p < 0.001) and WC (r = 0.507, p < 0.001). Strong positive correlations were also observed between BCAAs and fasting glucose, fasting insulin, HbA1c, and lipid parameters. In multivariable models, valine was independently and positively associated with central adiposity, as reflected by WC (standardized β = 0.357, p = 0.001), and with insulin resistance, as assessed by HOMA-IR (standardized β = 0.306, p = 0.003). Leucine and isoleucine were independently associated with WC and fasting insulin levels, while no independent associations were observed for phenylalanine or tyrosine.</p><p><strong>Conclusion: </strong>Valine is associated with central adiposity and insulin resistance in obesity and was independently associated with WC and HOMA-IR. BCAAs profiling may help identify individuals with increased metabolic risk; however, further prospective studies are required to validate its clinical and predictive value.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13326425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338078","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":"Non-insulin-dependent insulin resistance surrogate indexes for predicting chronic kidney disease in diabetic individuals: a prospective cohort study.","authors":"Xiaodie Mu, Hairong Li, Ting Huang, He Li","doi":"10.1186/s12902-026-02362-3","DOIUrl":"10.1186/s12902-026-02362-3","url":null,"abstract":"<p><strong>Background: </strong>Insulin resistance (IR) constitutes a significant pathological mechanism in chronic kidney disease (CKD) progression among individuals with diabetes. This study investigated the association between six non-insulin-dependent IR surrogate indexes and CKD risk in diabetic patients and evaluated their predictive performance.</p><p><strong>Materials and methods: </strong>Using data from the China Health and Retirement Longitudinal Study (CHARLS), multivariate Cox regression and nonlinear relationship analysis were employed to assess the association between non-insulin-dependent IR surrogate markers and CKD risk in diabetic population. Additionally, we assessed the predictive ability of each IR index by calculating the area under the curve (AUC), continuous net reclassification improvement (cNRI), and integrated discrimination improvement (IDI).</p><p><strong>Results: </strong>In total, 3,403 eligible participants were enrolled. Multivariate Cox analysis and Kaplan-Meier survival analysis demonstrated that CKD risk in the diabetic population increased with elevated of all IR indexes except eGDR. After adjusting for multiple confounders, estimated glucose disposal rate (eGDR) as a continuous variable revealed an inverse association with CKD risk [HR (95% CI): 0.914 (0.876, 0.954)]. Similarly, the highest eGDR quartile (Q4) maintained a significant protective association with CKD [HR (95% CI): 0.644 (0.488, 0.849] when analyzed by quartiles. All indexes demonstrated modest predictive performance, with eGDR showed the highest AUC, cNRI, and IDI.</p><p><strong>Conclusions: </strong>All IR surrogate indexes demonstrated significant associations with CKD risk in diabetic populations. The eGDR showed relatively better performance for CKD risk assessment, although the overall discriminative ability of all markers was modest in this population.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326806","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 phenotype stratification identifies patients at high risk of poor glycemic control in type 2 diabetes mellitus: Insights into hepatic metabolic dysfunction.","authors":"Wenxuan Qi, Wenhua Zhao, Li Chen","doi":"10.1186/s12902-026-02365-0","DOIUrl":"10.1186/s12902-026-02365-0","url":null,"abstract":"<p><strong>Background: </strong>To characterize metabolic dphenotypes based on integrated hepatic and metabolic indicators and evaluate their association with poor glycemic control in patients with Type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 320 patients with T2DM were retrospectively enrolled. Data on liver function, blood lipids, insulin resistance, and indicators related to fatty liver were collected. Unsupervised clustering analysis was performed to construct integrated metabolic risk profiles, and glycemic control levels were compared among different groups. Spearman correlation analysis was used to evaluate associations between hepatic metabolic indicators and glycated hemoglobin (HbA1c). Multivariate logistic regression analysis was conducted to identify independent risk factors for poorly controlled blood glucose. Multicollinearity among independent variables was assessed using variance inflation factors (VIF), with VIF < 5 considered indicative of acceptable collinearity. Predictive performance of the models was assessed using receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>Two metabolic risk profiles were identified, characterized by differences in hepatic enzyme levels, lipid metabolism, and insulin resistance. Patients in the high hepatic metabolic burden group (Cluster 2) exhibited significantly higher HbA1c levels and a greater incidence of poor glycemic control. HbA1c was positively correlated with alanine aminotransferase (ALT), aspartate aminotransferase (AST), severity of fatty liver, and homeostasis model assessment of insulin resistance (HOMA-IR), but negatively correlated with high-density lipoprotein cholesterol (HDL-C). Multivariate analysis revealed that longer diabetes duration, elevated AST and TG levels, higher HOMA-IR, and metabolic phenotypes classification (Cluster 2) were independent risk factors for poorly controlled blood glucose. The combined predictive model achieved an area under the ROC curve (AUC) of 0.943.</p><p><strong>Conclusion: </strong>Metabolic phenotype stratification based on integrated hepatic and metabolic indicators may facilitate identification of T2DM patients at increased risk of poor glycemic control and provide additional information for metabolic risk assessment.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of overt hypothyroidism and subclinical hypothyroidism in metabolic syndrome: a systematic review and meta-analysis.","authors":"Arman Shekarian, Sadegh Mazaheri-Tehrani, Saba Shekarian, Mahsa Setudeh, Melika Pourbazargan, Reza Amani-Beni, Maryam Heidarpour","doi":"10.1186/s12902-026-02376-x","DOIUrl":"10.1186/s12902-026-02376-x","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones regulate insulin sensitivity and lipid metabolism, both of which are central to metabolic syndrome (MetS). While previous systematic reviews have identified an association between MetS and hypothyroidism, the prevalence of overt hypothyroidism and subclinical hypothyroidism (SCH) in this population remains unclear, with reported rates varying widely. The present study aimed to estimate the prevalence of overt hypothyroidism and SCH in individuals with MetS.</p><p><strong>Methods: </strong>We searched PubMed, Embase, Scopus, and Web of Science from inception to February 10, 2025. Observational studies that reported the prevalence of overt hypothyroidism or SCH in more than 30 individuals with MetS were included. The risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for prevalence studies. Pooled prevalence estimates, corresponding 95% confidence intervals (CIs), and 95% prediction intervals (PIs) were calculated using the random-effects model.</p><p><strong>Results: </strong>Forty studies with a total of 25,008 MetS cases were included. The pooled prevalence estimates were 9.2% (95% CI: 6.2%; 12.7%) (95% PI: 0.0%; 32.7%) for overt hypothyroidism and 20.7% (95% CI: 15.6%; 26.3%) (95% PI: 0.1%; 60.1%) for SCH. Subgroup analysis and meta-regression indicated that high-risk-of-bias studies reported higher prevalence rates. Estimates from low-risk-of-bias studies, which are likely less affected by methodological biases, were 4.8% (95% CI: 1.9%; 8.9%) (95% PI: 0.0%; 24.8%) for overt hypothyroidism and 13.1% (95% CI: 9.1%; 17.8%) (95% PI: 0.5%; 38.2%) for SCH.</p><p><strong>Conclusion: </strong>Based on low-risk-of-bias studies, the prevalence of overt hypothyroidism in MetS does not appear substantially higher than estimates reported in the general population, whereas SCH is more common. The high prevalence of SCH in MetS and its potential adverse effects on MetS components highlight the potential clinical relevance of thyroid function testing in these individuals. Further cohort and trial studies are necessary to clarify the metabolic significance of SCH in patients with MetS and to determine whether its treatment provides clinical benefit.</p><p><strong>Systematic review registration number in prospero: </strong>CRD42024541953.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338061","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":"Occupational heavy metal exposure and endocrine-metabolic biomarkers: a retrospective analysis of 34,595 screened individuals in Türkiye.","authors":"Arzu Or Koca, Mustafa Cesur, Erman Çakal, Tuğba Akkale, İlhan Yetkin","doi":"10.1186/s12902-026-02388-7","DOIUrl":"10.1186/s12902-026-02388-7","url":null,"abstract":"<p><strong>Background: </strong>Heavy metals and trace elements can act as endocrine-disrupting chemicals and have been linked to thyroid, glucose, lipid, and hepatic abnormalities. We aimed to explore associations between routinely measured metal concentrations and biochemical/endocrinological parameters in a large occupational screening dataset from Türkiye.</p><p><strong>Methods: </strong>Records from 37,763 individuals evaluated at a national occupational and environmental diseases hospital between November 2021 and October 2023 were retrospectively reviewed; after prespecified exclusions, 34,595 unique participants were included. Metal measurements were performed in whole blood, serum, and urine samples as requested in routine surveillance; for each analyte, results were categorized as within or above the interpretive limit by the laboratory information system. Primary comparisons focused on arsenic, cadmium, lead, manganese, and zinc because of occupational relevance and sample size. Routine biochemistry, lipid profile, and thyroid function tests were extracted when available, and estimated glomerular filtration rate (eGFR, CKD‑EPI) was calculated.</p><p><strong>Results: </strong>Among participants with available thyroid function tests (n = 9,956), thyroid dysfunction was observed in 14.3% (subclinical hypothyroidism 11.9%). Among participants with available fasting glucose and/or HbA1c data (n = 20,738), diabetes mellitus and prediabetes criteria were met in 12.8% and 10.0%, respectively. In univariable comparisons, several metals above the interpretive limit were associated with differences in metabolic biomarkers, including lower HDL with elevated cadmium, lower HDL/LDL with elevated manganese, and higher ALT/AST and triglycerides with elevated zinc. Elevated metal strata differed in age and sex distribution. After within-metal false discovery rate correction, only a limited subset of biomarker differences remained significant.</p><p><strong>Conclusion: </strong>Among tested participants, thyroid dysfunction and dysglycemia were observed, and selected metal measurements above interpretive limits were associated with lipid and liver enzyme patterns. Given the clinically driven testing and limited covariate data, these findings should be interpreted as exploratory surveillance signals rather than workforce-level prevalence estimates. Heavy metal exposure may exert endocrine-disrupting effects on workers in relevant industries, particularly on thyroid function and glycemic regulation, suggesting that periodic surveillance of these parameters is warranted in exposure-prone workforces.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The correlation of CRP/Alb ratio with low muscle mass in patients with type 2 diabetes mellitus: a cross-sectional research.","authors":"Rui Wang, Wenchao Hu, Guotao Liu, Zheng Mou","doi":"10.1186/s12902-026-02392-x","DOIUrl":"10.1186/s12902-026-02392-x","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is a prominent age-related condition with low muscle mass, yet its underlying pathogenesis remains unclear. Type 2 diabetes mellitus (T2DM) is a well-recognized risk factor for this disorder. Recent data indicates that low muscle mass or sarcopenia is closely linked to high C-reactive protein-to-albumin (CRP/Alb) ratio in patients with esophageal, gastric and colorectal cancers.</p><p><strong>Methods: </strong>Therefore, this study aimed to investigate the association between the CRP/Alb ratio and low muscle mass in a T2DM population. This study included 1009 participants (549 males and 460 females) diagnosed with T2DM. Dual energy X-ray absorptiometry was utilized to measure the skeletal muscle index (SMI). Low muscle mass was identified based on the diagnostic criteria established by the Asian Working Group for Sarcopenia (AWGS).</p><p><strong>Results: </strong>Our findings revealed that low muscle mass was present in 110 male patients (20.04%) and 62 female patients (13.48%). In univariate logistic regression analysis, the C-reactive protein -to-Albumin ratio (CRP/Alb) was significantly associated with low muscle mass in men with T2DM (Odds Ratio (OR) = 1.084 [95%CI = 1.014 ~ 1.158], p = 0.017). The association remained significant after adjusting for age, triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), diastolic blood pressure (DBP) and body mass index (BMI) in the multiple logistic regression model (OR = 1.142 [95%CI = 1.028 ~ 1.269], p = 0.013). No significant association between CRP/Alb ratio and the risk of low muscle mass was observed in the female participants (OR = 0.975 [95%CI = 0.868 ~ 1.095], p = 0.672). In multiple linear regression analyses, SMI was positively associated with Alb, BMI, total cholesterol (TC) and HbA1c in males, but negatively related to associated with age. In females, SMI was positively associated with BMI and smoking duration.</p><p><strong>Conclusion: </strong>The CRP/Alb ratio was positively related to low muscle mass in men with T2DM.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338065","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":"Predicting permanent hypoparathyroidism after thyroidectomy: role of early postoperative parathyroid hormone levels and surgical factors.","authors":"Ahmet Akmercan, Kerim Deniz Batun, Ahmet Hakan Atalay, Muhammer Ergenç, Bahadir M Güllüoğlu, M Ümit Uğurlu","doi":"10.1186/s12902-026-02369-w","DOIUrl":"10.1186/s12902-026-02369-w","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to determine the incidence of permanent hypoparathyroidism (PH) after thyroidectomy and evaluate the association between PH and perioperative surgical, clinical, and biochemical factors.</p><p><strong>Methods: </strong>Patients who underwent total or completion thyroidectomy between 2017 and 2024 were retrospectively evaluated. PH was defined as a serum parathyroid hormone (PTH) level < 15 pg/mL and the need for active vitamin D, with or without calcium supplementation, to prevent hypocalcemic symptoms persisting for at least 6 months postoperatively. Patients were categorized according to PH status, and clinical, surgical, and biochemical parameters were analyzed.</p><p><strong>Results: </strong>Among the 498 eligible patients, 18 (3.6%) developed PH. A postoperative day 1 PTH level ≤ 7 pg/mL predicted PH with 86.7% sensitivity and 90.3% specificity and was an independent risk factor in multivariate analysis (odds ratio [OR]: 16.60, p < 0.001). Completion thyroidectomy was also independently associated with PH (OR: 6.14, p = 0.027). Postoperative day 1 calcium ≤ 8.3 mg/dL (OR: 14.20, p < 0.001) and the presence of parathyroid tissue in the surgical specimen (OR: 6.25, p < 0.001) were significant in univariate analysis but not in multivariate analysis (p = 0.08 and p = 0.056, respectively).</p><p><strong>Conclusions: </strong>Permanent hypoparathyroidism remains a clinically significant complication of thyroidectomy, with an incidence of 3.6% in our cohort. A postoperative day 1 PTH ≤ 7 pg/mL was independently associated with PH and demonstrated an excellent negative predictive value (99.4%), supporting its clinical utility for ruling out PH rather than confidently predicting it. Completion thyroidectomy was also independently associated with PH. Given the limited number of events, these findings warrant validation in larger, prospective cohorts.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9152,"journal":{"name":"BMC Endocrine Disorders","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148326878","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}