Endokrynologia Polska最新文献

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Introduction: Cabergoline (CAB) is the most used dopamine agonist in the treatment of prolactinomas. Studies related to the treatment of Parkinson's disease have shown that dopamine agonists can lead to fibrotic syndromes affecting the heart and the lung. The aim of this study was to evaluate the possible pulmonary side effects of CAB in prolactinoma patients.

Material and methods: Chest X-ray imaging and pulmonary function parameters like forced vital capacity (FVC), total lung capacity (TLC), and diffusion capacity for carbon monoxide (DLCO) were evaluated in 73 prolactinoma patients. The cumulative dose of CAB and the total duration of CAB use were also calculated, and all data were reviewed retrospectively.

Results: The median cumulative CAB dose was 192 mg, and the median duration of CAB use was 64 months. Only 13 patients (17%) among this cohort had abnormal DLCO results that could be an indirect sign of pulmonary fibrosis. These abnormal DLCO results were found not to be associated with cumulative CAB dose in these 13 patients.

Conclusions: CAB appears to be safe in terms of pulmonary functions with a median cumulative dose of 192 mg in prolactinoma patients.

Introduction: Diabetic peripheral neuropathy (DPN) and autonomic neuropathy are commonly coexistent in patients with type 2 diabetes mellitus (T2DM). Current assessment tools for diabetic neuropathy remain complicated and limited. We aimed to investigate the sonographic changes of the cervical vagus nerve in DPN patients with T2DM.

Material and methods: Patients with T2DM were divided into a DPN group (DPN, n = 44) and non-DPN controls (NDPN, n = 43) based on electromyogram results. Another 43 healthy controls (CON) were included. High-frequency ultrasound (HFU) of the vagus nerve was performed in all participants.

Results: Compared with controls, the honeycomb structure of the vagus nerve in patients with T2DM decreased, p < 0.001. The DPN group had higher cross-sectional area (CSA) of the right vagus nerve than the NDPN group (1.60 ± 0.52 vs. 2.00 ± 0.57 mm2, p =0.001). Logistic regression showed that right vagus nerve CSA was a risk factor of DPN (odds ratio [OR] = 3.924, p = 0.002). Right vagus nerve CSA was positively correlated with diabetes duration (p = 0.003), and negatively correlated with the motor conduction velocity (MCV) of the ulnar, median, and common peroneal nerves (p < 0.001 for all), as well as the sensor conduction velocity (SCV) of the ulnar and median nerve (both p < 0.005).

Conclusion: HFU shows thickening of the cervical vagus nerve in patients with DPN, which is a potential diagnostic feature of diabetic neuropathy.

Introduction: We usually use 131I-whole body scan (131I-WBS) and serum thyroglobulin (Tg) values to determine whether differentiated thyroid cancer (DTC) patients need to receive 131I treatment, but not all ¹³¹I-avid (functioning) patients have a good response to ¹³¹I therapy. Our study aims to assess the data of [¹⁸F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography ([¹⁸F] FDG PET/CT) to research the status of 131I-avid pulmonary metastases (PMs) and the prognosis of the patients.

Material and methods: The 131I-avid PMs of DTC patients who underwent [18F]FDG PET/CT scans were included. The maximum standardized uptake value (SUVmax), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) were used to estimate [¹⁸F]FDG uptake. The mean follow-up period was 34.14 ± 18.64 months. Progression-free survival (PFS) was estimated by the Kaplan-Meier method. The study was based on per-patient and per-lesion analyses.

Results: Among the 42 included patients, 34 (34/42, 81%) showed [¹⁸F]FDG uptake, which was defined as abnormal foci (SUVmax > 1.0) in the lungs. SUVmax, MTV, TLG, and tumour size were the factors that influenced the outcome of 131I treatment based on Tg levels (p = 0.000, 0.016, 0.000, 0.000) in per-lesion analysis. The only independent factor was the size of the lesion. There was a significant difference in response to ¹³¹I therapy between PMs with F-I+ and F+/I+ according to both Tg levels and Response Evaluation Criteria in Solid Tumours (RECIST) (version 1.1) (p = 0.044, 0.001), in the per-lesion analysis. When the changes in size or metabolism of some lesions are inconsistent the prognosis of these patients is poor (p = 0.003).

Conclusions: We concluded that higher [18F]FDG uptake and larger tumour size predict poor therapeutic effects and a high risk of disease progression in ¹³¹I-avid PMs of DTC. For evaluating the efficiency of ¹³¹I treatment, per-lesion analyses and assessing the data of [¹⁸F] FDG PET/CT would be more reliable than per-patient evaluation only. And early focal treatment modalities may improve their life span.

Introduction: The objective was to observe the expression of miR-23a-3p in the serum of patients with type 2 diabetic nephropathy (T2DN) and to explore its clinical significance.

Materials and methods: 112 patients with type 2 diabetes were divided into a simple diabetes mellitus (NON) group, T2DN microalbuminuria (MIC) group, and T2DN macroalbuminuria (MAC) group, according to the urinary protein-creatinine ratio (uACR). Clinical data were collected, miR-23a-3p levels in serum were measured by quantitative reverse transcription polymerase chain reaction (qRT-PCR), and clinical parameters were measured by an automatic biochemical analyser; the influencing factors of diabetic kidney disease (DKD) and the correlation between miR-23a-3p expression and clinical parameters were analysed.

Results: The expression of miR-23a-3p in the serum of the DKD group was lower than that of the normal control (CON) and NON groups. Correlation analysis showed that miR-23a-3p was positively correlated with urinary albumin (Albu), glycosylated haemoglobin (HbA1c), total cholesterol (CHOL), glycated albumin (GA-L), serum creatinine (Scr), fasting blood glucose (GLU), and uric acid (UA), negatively correlated with uACR and high-density lipoprotein cholesterol (HDL-C), but not correlated with urinary creatinine (CREA). The area under the receiver operating characteristic (ROC) curve (AUC) of miR-23a-3p for the diagnosis of DKD was 0.686 [95% confidence interval (CI): 0.599-0.773], with a sensitivity of 64.5% and a specificity of 71.2%; the AUC for differentiating NON from DKD was 0.700 (95% CI: 0.598-0.802), with a sensitivity of 61.8% and a specificity of 77.8%. Multivariate logistic regression analysis showed that serum miR-23a-3p levels were not associated with the development of DKD after adjusting for other levels of influence and were not significant for the differentiation of NON and DKD.

Conclusion: Serum miR-23a-3p levels are decreased in T2DN patients, and this change becomes more significant with the severity of the disease, which may be a marker for the early diagnosis and progression of T2DN.

Introduction: The aetiology of gender dysphoria is still unclear. Although prior studies have shown that trans men have higher androgen levels than cisgender women, they all concluded unselected populations. Our reason for performing this study is to evaluate trans men's hormone profile and metabolic status to compare with cisgender women in a more selected population. This is the first case-controlled study to compare anthropometric, metabolic, and endocrinological parameters of drug-naïve trans men with those of cisgender women.

Material and methods: We designed this study as a single-centre observational cohort study. We included 70 drug naïve trans men, and the control group comprised 34 healthy cisgender women. We measured and compared hormone profiles and metabolic parameters in the 2 groups.

Results: Of the 70 trans men individuals, 16 (22.85%) met the Rotterdam criteria and were diagnosed with polycystic ovary syndrome (PCOS); 4 individuals in the control group met the criteria (11.7%). Although we matched body mass index in the groups, total testosterone, free androgen index, androstenedione, 17 hydroxyprogesterone, muscle strength, triglyceride, and homeostatic model assessment of insulin resistance levels were significantly higher in the trans men than in the cisgender women (p < 0.05). Even after were excluded PCOS patients, hyperandrogenaemia was apparent in the trans men.

Conclusion: Our study showed that trans men have clearly higher androgen levels, which may have been the reason for metabolic changes compared to cisgender women. However, the main reason for hyperandrogenism in drug-naïve trans men is still not known, and more comprehensive studies are needed.

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Introduction: The aim of this prospective study was to establish the influence of baseline functional status on the incidence of falls.

Material and methods: The study was performed in an epidemiological sample of postmenopausal women from the RAC-OST-POL study. At baseline there were 978 postmenopausal women with a mean age of 65.9 ± 7.6 years, and at the end of 10-year follow-up 640 patients with a mean age of 65.04 ± 6.95 years remained in observation. Functional status was established at baseline using a stand up and go test (SAG) and the Lawton Instrumental Activities of Daily Living (IADL) scale. Afterwards, data on fall incidence were updated annually using phone interviews.

Results: In a 10-year period of observation, in 384 (60%) women at least one fall occurred. At baseline, 90% of subjects achieved maximal value in the IADL scale (24 points). Although the difference between mean IADL score in those who fell and did not fall was noticeable (23.50 ± 1.68 vs. 23.65 ± 1.47, respectively), the category of any IADL score below 24 points was significantly more frequent in women with falls (71.9% vs. 28.1%; chi-square 4.2, p < 0.05). The SAG score in the subgroup with falls was (10.75 ± 3.39) and did not differ in comparison to subgroup without falls (10.27 ± 2.72).

Conclusion: The baseline result of the IADL scale but not that of the SAG test are related to the incidence of falls in a 10-year prospective observation. Adequate correction of functional status may benefit patients and reduce the fall rate.