Clinical Endocrinology最新文献

We report additional evidence supporting growth hormone (GH) therapy in 5q35 duplication syndrome based on a patient case. A recent publication described a positive GH response in patients with NSD1-containing 5q35 duplications. Our case shows a similar favorable outcome, reinforcing previous findings in this ultra-rare disorder, for which clinical trials are not feasible due to low patient numbers. Well-documented individual cases remain valuable for guiding families, clinicians, and healthcare providers in treatment decisions.

Introduction: Whereas hypergonadotropic hypogonadism is incriminated for poor bone mass in adults with Turner syndrome (TS), studies are limited on bone mass acquisition in pubertal girls with this condition. In previous studies reporting low bone mass in pubertal girls with TS, the bone-mineral-density (BMD) was not adjusted for height, a major determinant of BMD in this group. The present study was designed to address this knowledge gap by looking at the effect of height-adjustment on BMD in pre-pubertal girls with TS.

Materials and methods: Eighty pre-pubertal girls with TS aged 12-18 years who did not receive GH or pubertal induction before the study, and 85 age-matched controls underwent BMD assessment by dual-energy X-ray absorptiometry (DXA) followed by stature corrections as per ISCD official positions. Bone turnover markers, P1NP (formation) and beta-CTX (resorption) were also assessed.

Results: TS patients had lower BMD both at lumbar spine (0.763 ± 0.116 gm/cm² vs. 0.938 ± 0.153 gm/cm², p < 0.001), total-body-less-head (0.696 ± 0.087 gm/cm2 vs. 0.761 ± 0.187 gm/cm2, p = 0.002) and non-dominant distal radius (0.592 ± 0.063 gm/cm² vs. 0.690 ± 0.081 gm/cm², = 0.006) compared to healthy controls. However, the differences disappeared at all sites following adjustment of the BMD values for stature using the bone mineral apparent density (BMAD) (0.275 ± 0.032 gm/cm³ vs. 0.286 ± 0.047 gm/cm³, p = 0.357) and height adjusted Z scores (-0.9 ± 1.3 vs. -1.5 ± 3.9, p = 0.496). The lower beta-CTX values in TS indicated reduced bone resorption. (0.81 ± 0.37 ng/mL vs. 1.05 ± 0.59 ng/mL, p = 0.036).

Conclusion: When adjusted for stature, bone mineral density in Turner Syndrome is not different from that of healthy girls of the same age.

Objective: Bariatric surgery has emerged as a potent intervention for ameliorating insulin resistance and its associated comorbidities in obese patients. Apolipoprotein J (ApoJ) and adiponectin are closely associated with insulin resistance and sensitivity, respectively. While changes in adiponectin levels following surgically induced weight loss have been intensively investigated, the response of ApoJ and its impact on metabolic parameters following bariatric surgery remain unclear. We aimed to elucidate serial changes in ApoJ levels and their associations with responses of adiponectin levels and critical metabolic parameters after Roux-en-Y gastric bypass (RYGB) surgery. Seven obese patients undergoing RYGB surgery were enrolled in this prospective study. Clinical and laboratory data were collected before surgery and at multiple time points from 1 day up to 12 months post-surgery. Serum levels of ApoJ, total adiponectin, and its multimeric forms, along with anthropomorphic and other metabolic parameters, were measured in the fasting state.

Results: Post-surgery, marked improvements were observed in anthropometric measures, and in serum levels of glucose, insulin, leptin, GLP-1, adiponectin, and homeostatic model assessment of insulin resistance (HOMA-IR) and insulin secretion (HOMA-ß). While ApoJ levels remained relatively stable, a positive association was seen with changes in leptin levels (r² = 0.499, p = 0.024); no association was found with changes in adiponectin levels.

Conclusions: These findings suggest that although overall ApoJ levels did not change significantly, individual temporal variations were associated with changes in leptin levels, indicating that ApoJ may serve as a potential biomarker after RYGB. Larger studies are needed to validate these observations.

Background: The purpose of the study was to determine changes in anabolic and catabolic hormone levels in response to various training regimens and to analyse their effect on skeletal muscle adaptation mechanisms through experimental measurement of physiological changes.

Design: The study used laboratory biochemical assays to assess anabolic and catabolic hormone levels, clinical observation to measure physiological changes (muscle mass, strength, endurance), and statistical methods (ANOVA, t-tests, correlation analysis) to assess group differences.

Methods and measurements: The study conducted an experimental analysis of hormonal changes in response to various types of physical activity, in particular, strength training, HIIT, and aerobic exercise.

Results: It was found that strength training contributed to the greatest increase in the level of anabolic hormones, which correlated with an increase in muscle mass (+12%) and strength (+35%), while HIIT provided a balanced improvement in strength indicators and endurance. Aerobic exercise caused minor changes in anabolic hormone levels but a significant increase in VO₂max (+30%) with an increase in cortisol (+5%). Changes in the levels of myokines were also found; in particular, irisin and osteocalcin, which play an important role in metabolic adaptation. The anabolic response was more pronounced in the younger participants (18-35 years), while in the older groups (36-50 and 51-60 years), the increase in muscle mass was less significant.

Conclusions: The identified patterns are important for sports medicine, endocrinology, and rehabilitation, in particular, for maintaining muscle mass and correcting hormonal changes in different age groups.

Background: University exams are recognised as naturalistic stressors that may elicit psychosocial and physiological responses in students. This pilot study investigated the short- and long-term effects of exam-related stress on hypothalamic-pituitary-adrenal (HPA) axis activity, focusing on cortisol production and rhythmicity.

Methods: Twenty-seven undergraduate students (aged 18-24 years) from a biological sciences programme participated. Hair cortisol concentrations were analysed for October (non-exam month) and November (exam month), while salivary cortisol was collected during 3 consecutive exam weekdays (Monday to Wednesday) at five daily time points to assess diurnal variation and the cortisol awakening response (CAR).

Results: Hair cortisol levels were significantly higher in November than in October, suggesting greater cumulative HPA activation during the exam period. Salivary cortisol displayed a general diurnal pattern and CAR across the week. Morning cortisol values showed a nonsignificant numerical increase across days, though overall daily cortisol output (AUC) remained stable.

Conclusion: Exam periods may be accompanied by elevated cumulative cortisol exposure while short-term HPA rhythmicity remains preserved. The combined use of hair and salivary biomarkers offers a multidimensional and feasible approach to investigating acute and cumulative stress responses in students. Larger longitudinal studies incorporating behavioural measures are warranted to confirm these findings.

Background and aims: Prediabetes-a reversible metabolic condition characterized by impaired fasting glucose, elevated HbA1c, or reduced glucose tolerance-is a major precursor to type 2 diabetes mellitus (T2DM), especially in high-risk populations like India. This review evaluates the impact of culturally tailored lifestyle interventions in preventing type 2 diabetes in adults with prediabetes.

Methods: This PRISMA-compliant systematic review (PROSPERO: CRD420251085667) included RCTs from 2020 to 2025 on adults (≥18 years) with prediabetes. It assessed lifestyle interventions-diet, exercise, yoga, and behavioral support-using the Jadad scale and Downs & Black checklist.

Results: Six high-quality RCTs demonstrated significant improvements in glycemic parameters, cardiometabolic profiles, and reductions in diabetes incidence. Yoga-based protocols yielded notable declines in HbA1c and stress biomarkers. Dietary counseling and formula diets achieved normoglycemia and metabolic benefits independent of weight loss. Long-duration interventions also reduced frailty and disability risks, enhancing overall health outcomes.

Conclusions: Culturally adapted lifestyle interventions show strong efficacy and scalability in reversing prediabetes and reducing progression to T2DM. Integration of such strategies into national diabetes prevention programs may enhance sustainable metabolic health and address the unique needs of high-risk populations.

Objective: Type 2 diabetes mellitus (T2DM) is a chronic, progressive disease that requires long-term glycemic control. The long-term real-world evidence for glucagon-like peptide-1 receptor agonists remains limited. This study aimed to evaluate the sustained glycemic and weight-lowering effects of dulaglutide in patients with T2DM who had maintained therapy for at least 3 years.

Methods: This retrospective cohort study analyzed 403 patients with T2DM who were treated continuously with weekly doses of dulaglutide for ≥ 3 years between 2016 and 2023 at a single tertiary hospital. Baseline and follow-up data on glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and body weight were also assessed.

Results: The participants had a mean age of 60.0 years, with a mean diabetes duration of 17.4 years. Over a mean follow-up of 4.3 years, HbA1c decreased from 8.7% (72 mmol/mol) to 7.6% (60 mmol/mol), reflecting a mean reduction of 1.1% (12 mmol/mol) (p < 0.001), and body weight decreased by 2.9 kg (p < 0.001). Baseline HbA1c level was the strongest predictor of glycemic improvement.

Conclusions: Dulaglutide provided durable improvements in glycemic control and weight reduction for more than 3 years, even in patients with long-standing T2DM and comorbidities. These results support its role as a long-term treatment option in real-world clinical practice.

Osmancevic A, Daka B, Michos ED, Trimpou P, Allison M. Clin Endocrinol (Oxf). 2023 Aug;99(2):190-197. doi:10.1111/cen.14930. Epub 2023 May 23. PMID: 37221937; PMCID: PMC10330714.

In paragraph 3.1, there was a description error in the text related to the associations between IL-6, testosterone, and SHBG, as presented in Table 2.

We apologize for the errors.