Endokrynologia Polska最新文献

{"title":"Calcitonin and procalcitonin measurement after cholecystokinin-2/gastrin receptor agonist stimulation in patients with advanced medullary thyroid cancer: results from the GRAN-T-MTC study.","authors":"Małgorzata Trofimiuk-Müldner, Katica Bajuk Studen, Paola Anna Erba, Luka Lezaic, Clemens Decristoforo, Katja Zaletel, Petra Kolenc, Elwira Przybylik-Mazurek, Irene Virgolini, Alide C Fröberg, Anna Skalniak, Renata Mikołajczak, Marion de Jong, Bogdan Solnica, Danuta Fedak, Paulina Gaweda, Christine Rangger, Konrad Skórkiewicz, Alicja Hubalewska-Dydejczyk","doi":"10.5603/ep.106662","DOIUrl":"10.5603/ep.106662","url":null,"abstract":"<p><strong>Introduction: </strong>Medullary thyroid cancer (MTC) is characterized by overexpression of cholecystokinin-2/gastrin receptors (CCK2R). There are limitations of calcitonin as a tumor marker in MTC diagnosis and prognosis. Procalcitonin is gaining a role as a complementary tumor marker. This study aimed to assess the feasibility of procalcitonin measurements on top of the calcitonin measurements after CCK2R agonist stimulation in patients with MTC.</p><p><strong>Material and methods: </strong>The assessment was part of the GRAN-T-MTC translational study conducted through a Phase I multicenter clinical trial in patients with locally advanced and/or disseminated MTC. Patients were administered intravenously the CCK2R agonist CP04 labelled with indium-111 ([¹¹¹In]In-CP04); the first four patients at a lower mass amount of 10 μg, and afterwards the whole group at a higher mass amount of 50 μg. Blood samples for calcitonin and procalcitonin measurements were obtained shortly before and 2, 5, 10, and 20 minutes after start of [¹¹¹In]In-CP04 administration.</p><p><strong>Results: </strong>Sixteen patients were included in the study. After injection of the higher mass amount of [¹¹¹In]In-CP04, the median maximum ratio for stimulated calcitonin was 2.97 (interquartile range [IQR] 2.35) pg/mL and procalcitonin 2.01 (IQR 2.07) pg/mL. The maximum stimulated/baseline calcitonin ratio was 5.2 ± 4.0 and 4.1 ± 3.8 in the low and high mass amount groups, respectively, and the maximum stimulated/baseline procalcitonin ratio was 4.6 ± 5.1 and 2.9 ± 3.1 in the low and high mass amount groups, respectively. There was a significant linear correlation between calcitonin and procalcitonin concentrations (p < 0.001) at each test time point and between the maximum procalcitonin and maximum calcitonin increment ratio (r = 0.94, p < 0.0001). Mild, short-lasting side effects (transient tachycardia, flushing) were observed in one patient during the injection of low and in two patients during the injection of high mass amount of [¹¹¹In] In-CP04. The side effects were not related to the baseline calcitonin or procalcitonin concentrations.</p><p><strong>Conclusion: </strong>Procalcitonin concentrations after CP04 stimulation were highly correlated with calcitonin concentrations. Unlabeled CP04, if available commercially, may be considered an alternative stimulating agent in MTC patients, even in lower mass amounts. Further studies, including healthy controls, are required to prove this concept and calculate the diagnostic thresholds.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 3","pages":"321-330"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normalization strategies in neonatal steroid metabolomics: a comparative analysis of probabilistic quotient and peer group approaches.","authors":"Miłosz Lorek, Teresa Joanna Stradomska, Anna Siejka, Janusz Fuchs, Dominika Januś, Aneta Gawlik-Starzyk","doi":"10.5603/ep.106090","DOIUrl":"10.5603/ep.106090","url":null,"abstract":"<p><strong>Introduction: </strong>Steroid metabolomics in neonatal populations is challenged by considerable physiological heterogeneity and technical variability, which complicate the interpretation and comparability of metabolite profiles. Effective normalization strategies are essential to ensure accurate data analysis in this context.</p><p><strong>Material and methods: </strong>We analyzed 24-hour urinary steroid profiles in a cohort of 50 neonates (including very preterm, late preterm, and full-term infants) using gas chromatography-mass spectrometry. Two normalization techniques were compared: probabilistic quotient normalization (PQN) and peer group normalization (PGN). Normalization performance was assessed via distribution metrics, correlation with anthropometric variables, and principal component analysis (PCA).</p><p><strong>Results: </strong>PGN achieved superior distributional normalization, with 27 of 30 metabolites conforming to normality assumptions, compared to 21 using PQN. PGN also eliminated all significant correlations between steroid levels and anthropometric parameters, indicating effective reduction of physiological confounding. In contrast, PQN partially mitigated such associations but was less robust in handling high-abundance metabolites. PCA confirmed improved sample dispersion and group separation after normalization, with method-dependent differences in Scores Plot.</p><p><strong>Conclusions: </strong>Peer group normalization is a sophisticated approach to reducing physiological variability in neonatal steroid profiling. These observations lend further credence to PGN as a promising strategy for standardizing steroid metabolomics in the field of neonatology. Nevertheless, further validation is necessary to substantiate these findings.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 3","pages":"331-338"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological insights into primary hyperparathyroidism: a comprehensive single-center retrospective study.","authors":"Dorota Anna Brodowska-Kania, Marek Saracyn, Natalia Osial, Adrianna Mróz, Bartłomiej Grala, Olga Remyzovska, Adam Daniel Durma, Michał Wiłkojć, Piotr Kowalewski, Piotr Zięcina, Maciej Kołodziej, Grzegorz Kamiński","doi":"10.5603/ep.106029","DOIUrl":"10.5603/ep.106029","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperparathyroidism (PHPT) is caused by excessive hormone secretion from one or more parathyroid glands. Based on their morphological and immunophenotypic characteristics, parathyroid glands can be considered as neuroendocrine organs, and their neoplasms as neuroendocrine tumors. The 2022 World Health Organization (WHO) Classification of Endocrine and Neuroendocrine Tumors introduced updated diagnostic criteria, advancing the understanding of parathyroid neoplasms. This study aimed to analyze the clinicopathological features of PHPT, emphasizing tumor localization and histopathological findings.</p><p><strong>Material and methods: </strong>The retrospective study analyzed 39 surgically treated patients for PHPT at a single tertiary referral center between 2022 and 2024. Localization methods included neck ultrasonography (US), technetium-99m methoxyisobutylisonitrile single photon emission computed tomography/computed tomography ([99mTc]Tc-MIBI SPECT/CT), and ¹⁸F-fluorocholine positron emission tomography/computed tomography (¹⁸F-FCH PET/CT). Postoperative histopathological evaluation of specimens was conducted according to the 2022 WHO criteria.</p><p><strong>Results: </strong>The cohort comprised 85% female patients with a mean age of 57.8 years. Lower parathyroid glands were more frequently affected, reflecting their distinct embryological origins. Pathological analysis identified 77.5% parathyroid adenomas (PA), 12.5% atypical parathyroid tumors (APT), and 7.5% parathyroid carcinomas (PC), with the incidence of APT and PC exceeding reported ranges. PET/CT showed superior diagnostic accuracy (100% detection) compared to neck US (65.8%) and [99mTc]Tc-MIBI SPECT/CT (65.7%). Maximum standardized uptake value (SUVmax) from PET/CT significantly correlated with serum calcium, PTH concentration, and lesion volume, suggesting their utility as markers of metabolic activity. Surgery achieved a 92.3% cure rate, with successful reoperations in all recurrent cases.</p><p><strong>Conclusions: </strong>The study underscores the neuroendocrine nature of parathyroid glands, highlights the diagnostic value of the updated WHO classification, and demonstrates the superior accuracy of 18F-FCH PET/CT in localizing parathyroid lesions. A deeper understanding of the neuroendocrine characteristics of parathyroid glands and their embryological migration patterns could further improve diagnostic and therapeutic strategies. Early diagnosis and precise localization of affected parathyroid glands remain critical for achieving curative outcomes in PHPT.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"522-533"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The urinary calcium-magnesium product as a potential indicator of nephrolithiasis in primary hyperparathyroidism.","authors":"Michał Popow, Sebastian Szewczyk, Janusz Sierdziński, Małgorzata Bobrowicz, Urszula Ambroziak","doi":"10.5603/ep.106907","DOIUrl":"10.5603/ep.106907","url":null,"abstract":"<p><strong>Introduction: </strong>Nephrolithiasis is a common complication of primary hyperparathyroidism (PHPT), but the mechanisms underlying stone formation remain incompletely understood. Calcium-sensing receptor (CaSR) activity, indirectly assessed by serum calcitriol levels and urinary excretion of calcium and magnesium, may influence the risk of nephrolithiasis. Current diagnostic methods are cumbersome, prompting the need for more practical biomarkers. This study aimed to evaluate a novel parameter - calcium and magnesium fractional excretion (CAMFE) - as a predictor of nephrolithiasis risk in patients with PHPT.</p><p><strong>Material and methods: </strong>A retrospective analysis was conducted on 109 patients with PHPT. CAMFE was calculated from 24-hour urine collection under a standard diet. Associations with nephrolithiasis were analyzed using logistic regression and receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Nephrolithiasis was present in 40% of patients. The CAMFE index was correlated significantly with kidney stone formation. Calcitriol levels were higher in stone formers, supporting its role in enhanced intestinal calcium absorption. CAMFE showed good predictive power with an optimal cut-off value of 6.18, offering a simpler alternative to dual urine collection protocols.</p><p><strong>Conclusions: </strong>Low CAMFE (< 6.18) may be connected with a higher risk of nephrolithiasis, potentially serving as a useful marker for assessing the risk of renal complications in patients with PHPT.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"516-521"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphocytic colitis as a new disease possibly associated with autoimmune polyendocrine syndrome type 2 (APS-2).","authors":"Lidia Ziobro, Wiktoria Suchy, Ewa Płaczkiewicz-Jankowska, Małgorzata Trofimiuk-Müldner, Alicja Hubalewska-Dydejczyk","doi":"10.5603/ep.107241","DOIUrl":"10.5603/ep.107241","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"571-572"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of glycated hemoglobin (HbA1c) on outcomes in differentiated thyroid cancer with type 2 diabetes mellitus.","authors":"Merve Çatak, Zeynep Çetin, Özden Özdemir Başer, Asım Kocabay","doi":"10.5603/ep.107896","DOIUrl":"10.5603/ep.107896","url":null,"abstract":"<p><strong>Introduction: </strong>Type 2 diabetes mellitus (T2DM) is a frequent comorbidity in differentiated thyroid cancer (DTC). This study evaluated the impact of glycemic control, particularly glycated hemoglobin (HbA1c) levels, on tumor characteristics and treatment outcomes.</p><p><strong>Material and methods: </strong>We retrospectively analyzed 302 DTC patients, including 58 (19.2%) with T2DM. Baseline demographic, clinical, and pathological data were collected. Treatment response was assessed as per American Thyroid Association (ATA) guidelines. Logistic regression identified predictors of non-excellent response, and a subgroup analysis was performed among diabetic patients stratified by HbA1c (< 7% vs. ≥ 7%).</p><p><strong>Results: </strong>T2DM patients were older (p < 0.001), with more bilateral tumors (p = 0.047) and higher tumor foci (p = 0.039). Other tumor features were similar between groups. In multivariate analysis, both HbA1c[odds ratio (OR): 1.307, 95% confidence interval (CI): 1.014-1.683, p = 0.038) and lymph node metastasis (OR: 3.932, 95% CI: 1.000-15.464, p = 0.050] independently predicted non-excellent response. Among diabetics, HbA1c ≥ 7% was associated with higher non-excellent response rates (p = 0.030).</p><p><strong>Conclusion: </strong>Poor glycemic control, rather than T2DM itself, was linked to suboptimal treatment response. HbA1c may serve as a simple prognostic marker in diabetic patients with DTC.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"507-515"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thymic well-differentiated neuroendocrine tumor with isolated bone marrow metastases: an unusual metastatic pattern.","authors":"Katarzyna Jóźwik-Plebanek, Marek Saracyn, Weronika Mądra, Maciej Kołodziej, Adam Durma, Bartłomiej Grala, Katarzyna Gniadek-Olejniczak, Rafał Stec, Grzegorz Kamiński","doi":"10.5603/ep.105376","DOIUrl":"10.5603/ep.105376","url":null,"abstract":"<p><p>Not required for Clinical Vignette.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"345-346"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibodies against the receptor for insulin-like growth factor 1 (IGF-1RAb), insulin-like growth factor 1 (IGF-1), and insulin-like growth factor binding protein 3 (IGFBP-3) in the serum of patients with Graves' and Basedow's disease with and without orbitopathy.","authors":"Mariusz Nowak, Tomasz Wielkoszyński, Magdalena Londzin-Olesik, Wojciech Nowak, Bogdan Marek, Beata Kos-Kudła, Lucyna Siemińska, Joanna Głogowska-Szeląg, Dariusz Kajdaniuk, Jacek Karpe","doi":"10.5603/ep.102336","DOIUrl":"10.5603/ep.102336","url":null,"abstract":"<p><strong>Introduction: </strong>Proven risk factors for thyroid orbitopathy (TO) are thyroid dysfunction, smoking, and high levels of thyrotropin receptor antibodies (TRAb), and the role of insulin-like growth factor 1 (IGF-1), the receptor for IGF-1 (IGF-1R), and antibodies to the receptor for IGF-1 (IGF-1RAb) are also debated. IGF-1R is overexpressed in fibroblasts and orbital lymphocytes in TO patients. It forms a functional complex and mediates signal transduction through thyroid stimulating hormone receptor (TSHR). The study aimed to evaluate the levels of IGF-1RAb, IGF-1, and IGFBP-3 in a group of Graves' and Basedow's disease (GBD) patients with or without TO.</p><p><strong>Material and methods: </strong>Sixty-seven patients were included in the study, including 47 GBD and 20 control patients. In the GBD group, 31 patients were diagnosed with active TO and were treated with immunosuppressive therapy according to the standard of European Group on Graves' Orbitopathy (EUGOGO) guidelines. In this group, 10 patients were in the sight-threatening stage of TO severity according to EUGOGO classification. IGF-1 and IGFBP-3 levels were determined with the use of chemiluminescence immunoassay (CLIA) methods. IGF-1RAb was measured by the \"in-house\" constructed enzyme-linked immunosorbent assay (ELISA) method.</p><p><strong>Results: </strong>Including our cut-off value (Q75 - 232.48 ng/mL), positive serum IGF-1RAb was found in 25% of patients in the control group (5 out of 20 patients), in 38.3 % (18 out of 47 patients) of patients with GBD, and in 22.5% of GBD patients with active TO (7 out of 31 patients). In GBD patients with active TO, there were no differences in IGF-1RAb when compared to the control group but with a significantly lower level when compared to the GBD patients without active TO. The group of patients with active TO in the sight-threatening stage had significantly lower values of IGF-1RAb compared to the group of patients with GBD without the presence of TO (p = 0.004). There was also a difference in IGF-1RAb concentration between the groups in moderate-to-severe and sight-threatening stages of TO before starting immunosuppressive treatment (p = 0.014). There was no difference in IGF-1 levels between the control group and GBD patients with active TO before starting immunosuppressive treatment and GBD patients without active TO. The was a significant difference in IGF-1 concentration between the group with moderate-to-severe and sight-threatening stages of TO before starting immunosuppressive treatment (p = 0.009). We found significantly lower IGFBP-3 concentrations in GBD patients regardless of the presence of TO compared to the control group (p = 0.016). There was no difference in IGFBP-3 concentrations between patients with moderate-to-severe and sight-threatening stages of TO (p = 0.203).</p><p><strong>Conclusion: </strong>It seems that high IGF-1RAb levels may have a protective effect against the onset or severe course of TO,","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 1","pages":"40-51"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framework guidelines for the process of caring for the health of adolescent transgender (T) and non-binary (NB) people experiencing gender dysphoria - the position statement of the expert panel.","authors":"Aneta Gawlik-Starzyk, Marta Dora, Dorota Baran, Łukasz Szostakiewicz, Małgorzata Trofimiuk-Müldner, Łukasz Müldner-Nieckowski, Agnieszka Bielska-Brodziak, Milena Adamczewska-Stachura, Aleksandra Antosz, Katarzyna Bajszczak, Ewa Barg, Barbara Barteczka-Eckert, Aleksandra Chodecka, Lena Cichoń, Ewa Dobiała, Agnieszka Drosdzol-Cop, Izabela Fornalik, Justyna Holka-Pokorska, Grzegorz Iniewicz, Tomasz Jakubowski, Małgorzata Janas-Kozik, Karina Kapczuk, Julia Kata, Tomasz Koszutski, Grzegorz Kudela, Joanna Ławicka, Anna Mazurczak, Magdalena Mijas, Magdalena Nowacka, Beata Pastwa-Wojciechowska, Katarzyna Pilarczyk-Parchanowicz, Paulina Pilch, Maciej Pilecki, Dominik Rachoń, Barbara Remberk, Violetta Skrzypulec-Plinta, Jagoda Sikora, Sylwia Stankiewicz, Maria Szarras-Czapnik, Marta Szymańska-Pytlińska, Mieczysław Walczak, Krzysztof Wilczyński, Beata Wróbel, Bartosz Grabski","doi":"10.5603/ep.104289","DOIUrl":"10.5603/ep.104289","url":null,"abstract":"<p><p>This article presents framework guidelines for the care of adolescent transgender (T) and non-binary (NB) individuals experiencing gender dysphoria (GD) and/or gender incongruence (GI). Developed by a multidisciplinary expert panel, these guidelines aim to address the complex medical, psychological, and social needs of this diverse population. The document emphasises the importance of individualised, affirmative care that respects the autonomy, identity, and rights of adolescents. It outlines best practices for psychiatric, psychological, and sexological assessment; criteria and protocols for gender-affirming hormonal interventions (GAHI) and puberty suppression; and ethical considerations for medical decision-making. The guidelines advocate for comprehensive support systems, including family involvement and multidisciplinary team collaboration, while addressing co-occurring mental health conditions and neurodiversity. The article also highlights global perspectives on gender-affirming care, comparing practices and policies across countries to provide a contextualised approach that aligns with international standards while addressing local legal and healthcare frameworks. The proposed care model is designed to enhance the mental and physical well-being of adolescents, reduce stigma, and improve their overall quality of life. This work serves as a vital resource for healthcare professionals, policymakers, and advocates seeking to advance equitable, effective, and compassionate care for gender-diverse youths.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":"76 1","pages":"1-28"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between adipose insulin resistance, serum lipoprotein(a) level, and MASLD in adult patients with T2DM in China.","authors":"Yufang Liu, Jianbin Sun, Xiaomei Zhang","doi":"10.5603/ep.103993","DOIUrl":"10.5603/ep.103993","url":null,"abstract":"<p><strong>Introduction: </strong>The aim was to explore the correlation between adipose tissue insulin resistance and metabolic dysfunction-associated steatotic liver disease (MASLD), and to assess how the serum lipoprotein(a) [Lp(a)] level modifies the association between adipose insulin resistance and MASLD.</p><p><strong>Material and methods: </strong>We analyzed hospitalized type 2 diabetes mellitus (T2DM) patients and calculated the adipose insulin resistance (Adipo-IR) index as the product of the fasting insulin and free fatty acid concentration. There were 2247 participants in the study, 64.6% (n = 1452) with MASLD.</p><p><strong>Results: </strong>Compared to subjects in the first quartile of the Adipo-IR index, there were 1.29 [odds ratio (OR): 2.29, 95% confidence interval (CI): 1.56-3.36], 2.55 (OR: 3.55, 95% CI: 2.34-5.37), and 2.00 (OR: 3.00, 95% CI: 1.94-4.63) fold higher odds of having MASLD among subjects in the second, the third, and the fourth Adipo-IR index quartile, respectively. As the Adipo-IR index was in the range lower than 7.5, Adipo-IR was a risk factor for MASLD (OR: 1.349, 95%CI: 1.226-1.484). Conversely, if the Adipo-IR index was higher than 7.5, it became a protective factor for MASLD (OR: 0.980, 95% CI: 0.964-0.997). Subjects with high Lp(a) and low Adipo-IR showed the lowest risk of MASLD. Compared to this group, the ORs of MASLD was 2.411 (95% CI: 1.590-3.656) for the high Adipo-IR and low Lp(a) group, 2.770 (95% CI: 1.808-4.246) for the high Adipo-IR and high Lp(a) group, and 1.473 (95% CI: 1.003-2.164) for the low Adipo-IR and low Lp(a) group.</p><p><strong>Conclusions: </strong>In patients with T2DM, with the increase of Adipo-IR, the incidence of MASLD showed a trend of first an increase and then a decrease. Among patients with T2DM, those with low Adipo-IR combined with high Lp(a) had the lowest risk of developing MASLD.</p>","PeriodicalId":93990,"journal":{"name":"Endokrynologia Polska","volume":" ","pages":"415-422"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}