Clinical Endocrinology最新文献

Objectives: The objective of this study was to develop and validate a nomogram model integrating clinical, biochemical and ultrasound features to predict the malignancy rates of Thyroid Imaging Reporting and Data System 4 (TR4) thyroid nodules.

Methods: A total of 1557 cases with confirmed pathological diagnoses via fine-needle aspiration (FNA) were retrospectively included. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors of malignancy. These predictors were incorporated into the nomogram model, and its predictive performance was evaluated using receiver-operating characteristic curve (AUC), calibration plots, net reclassification improvement (NRI), integrated discrimination improvement (IDI) and decision curve analysis (DCA).

Results: Eight out of 22 variables-age, margin, extrathyroidal extension, halo, calcification, suspicious lymph node metastasis, aspect ratio and thyroid peroxidase antibody-were identified as independent predictors of malignancy. The calibration curve demonstrated excellent performance, and DCA indicated favourable clinical utility. Additionally, our nomogram exhibited superior predictive ability compared to the current American College of Radiology (ACR) score model, as indicated by higher AUC, NRI, IDI, negative likelihood ratio (NLR) and positive likelihood ratio (PLR) values.

Conclusions: The developed nomogram model effectively predicts the malignancy rate of TR4 thyroid nodules, demonstrating promising clinical applicability.

Purpose: Adipose tissue has an important endocrine function by secreting a variety of hormones known as adipokines, such as Visfatin, Omentin-1 and Chemerin. On the other hand, these hormones are also secreted from places other than fatty tissues in the girl's genital system. The goal of this study was to demonstrate the secretory status of adipokines in patients with central precocious puberty (CPP) and their utility in the diagnosis of precocious puberty.

Method: A total of 105 patients were included in the study (53 in the CPP group and 52 in the control group). The following were used as the CPP diagnostic criteria; breast development, basal LH measurement higher than 0.3 IU/L, peak LH level ≥ 5 IU/L, peak LH/FSH ratio ≥ 0.66 (after 0.1 mg GnRH stimulation test) and a difference of at least 1 year between bone and chronological age.

Results: A statistically significant difference was detected between the groups in serum Omentin-1 and Chemerin levels, and no significant differences were detected between the groups in Visfatin values. The cut-off values for the diagnosis of CPP were calculated as ≤ 48.9 with 81% sensitivity and 54% specificity for Omentin-1, and as ≥ 417 with 85% sensitivity and 60% specificity for Chemerin.

Conclusion: In our study, we found that Omentin-1 level decreased and Chemerin level increased in lean girls with CPP. More studies are needed to elucidate how adipokines play roles in explaining the onset of CPP, and whether they may be used as a reliable marker for the diagnosis of CPP.

Premature ovarian insufficiency (POI, defined as age at menopause < 40 years) affects 1%-3% of postmenopausal women. It is positively associated with an increased risk of diabetes mellitus, arterial hypertension, cardiovascular disease, osteoporosis, fractures, cognitive impairment, and depression. Early menopause (EM, defined as age at menopause < 45 years) is also associated with these adverse health consequences, in most cases to the same degree as in POI. Therefore, a unifying term for EM and POI, such as 'premature menopause', may be proposed, using the age threshold of < 45 years. This could provide broader coverage of these women, substantiating the need for prompt administration of menopausal hormone therapy (in this case, 'hormone replacement therapy'). However, the benefits of this approach, which precludes a higher oestrogen dose up to the normal age of menopause, need to be proven in well-designed randomized controlled trials.