Background: Successful ablation in 131I therapy for differentiated thyroid cancer (DTC) includes both remnant ablation (RA) and radioiodine adjuvant therapy (RAT). This study aimed to differentiate between the therapeutic efficacies of RA and RAT, investigate the factors associated with their effectiveness, and assess their impact on prognosis.
Methods: This retrospective study included patients with DTC who underwent initial 131I therapy at our tertiary center. The successful RA (SRA) and successful RAT (SRAT) was determined based on the 131I-diagnostic whole-body scan (Dx-WBS), TSH-stimulated thyroglobulin (sTg) levels, and neck ultrasound at the 6th month after 131I therapy. The patients were divided into complete response and persistent/recurrent disease groups during the follow-up period.
Results: A total of 232 patients were included, 91.8% (213/232) of patients achieved SRA, only 8.1% (19/232) failed RA (FRA). Among the 213 patients in the SRA group, 70.4% (150/213) achieved SRAT and 29.6% (63/213) failed RAT (FRAT). Only pre-ablation sTg >10 ng/mL (OR = 46.968, 95% CI 9.731-226.699, P < 0.001) was an independent risk factor predicting the failure of RAT. The prognostic analysis included 215 patients, and 6.1% (13/215) were classified as persistent/recurrent disease at the last follow-up. Both pre-ablation sTg >10 ng/mL (HR = 4.765, 95% CI 1.371-16.566, P = 0.014) and FRAT (HR = 10.104, 95% CI 1.071-95.304, P = 0.043) independently predicted persistent/recurrent disease.
Conclusions: RA is easy to achieve successfully, whereas RAT evaluation provides greater value than RA for prognosis prediction. For patients with low Tg levels and no imaging evidence of disease, routine Dx-WBS during follow-up has minimal significance.
{"title":"Therapeutic efficacies of remnant ablation and radioiodine adjuvant therapy in differentiated thyroid cancer.","authors":"Yanlin Liu, Shuhui Huang, Xiaohui Li, Tian Tian, Rui Huang","doi":"10.1007/s12020-024-04064-z","DOIUrl":"10.1007/s12020-024-04064-z","url":null,"abstract":"<p><strong>Background: </strong>Successful ablation in <sup>131</sup>I therapy for differentiated thyroid cancer (DTC) includes both remnant ablation (RA) and radioiodine adjuvant therapy (RAT). This study aimed to differentiate between the therapeutic efficacies of RA and RAT, investigate the factors associated with their effectiveness, and assess their impact on prognosis.</p><p><strong>Methods: </strong>This retrospective study included patients with DTC who underwent initial <sup>131</sup>I therapy at our tertiary center. The successful RA (SRA) and successful RAT (SRAT) was determined based on the <sup>131</sup>I-diagnostic whole-body scan (Dx-WBS), TSH-stimulated thyroglobulin (sTg) levels, and neck ultrasound at the 6th month after <sup>131</sup>I therapy. The patients were divided into complete response and persistent/recurrent disease groups during the follow-up period.</p><p><strong>Results: </strong>A total of 232 patients were included, 91.8% (213/232) of patients achieved SRA, only 8.1% (19/232) failed RA (FRA). Among the 213 patients in the SRA group, 70.4% (150/213) achieved SRAT and 29.6% (63/213) failed RAT (FRAT). Only pre-ablation sTg >10 ng/mL (OR = 46.968, 95% CI 9.731-226.699, P < 0.001) was an independent risk factor predicting the failure of RAT. The prognostic analysis included 215 patients, and 6.1% (13/215) were classified as persistent/recurrent disease at the last follow-up. Both pre-ablation sTg >10 ng/mL (HR = 4.765, 95% CI 1.371-16.566, P = 0.014) and FRAT (HR = 10.104, 95% CI 1.071-95.304, P = 0.043) independently predicted persistent/recurrent disease.</p><p><strong>Conclusions: </strong>RA is easy to achieve successfully, whereas RAT evaluation provides greater value than RA for prognosis prediction. For patients with low Tg levels and no imaging evidence of disease, routine Dx-WBS during follow-up has minimal significance.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"734-743"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-05DOI: 10.1007/s12020-024-04029-2
David Tak Wai Lui, Kimberly Hang Tsoi, Carol Ho Yi Fong, Nancy Su Jiang, Wing Sun Chow, Michele Mae Ann Yuen
Purpose: Naltrexone-bupropion (Contrave®) has shown efficacy and safety in large randomised controlled trials, predominantly comprising Caucasians. Data are limited in Asian populations. We carried out a retrospective matched cohort study of Chinese patients with obesity to evaluate the efficacy and safety of naltrexone-bupropion in real-world clinical practice.
Methods: We performed a retrospective matched cohort study of Chinese patients with obesity managed in the Obesity Clinic of Queen Mary Hospital in Hong Kong between 1 January 2016 and 31 December 2020. Electronic health records of patients treated with naltrexone-bupropion were retrieved for body weight and height, obesity-related metabolic parameters, and adverse events over a 12-month period. Age- and sex-matched controls from the Obesity Clinic who were only on self-directed lifestyle management were identified for comparison of weight changes. General linear models were used to analyse the change in body weight over 12 months.
Results: Thirty-seven patients treated with naltrexone-bupropion were included (mean age 42.2 ± 8.4 years, 54.1% men, baseline body mass index 37.3 ± 4.6 kg/m2), and 37 age- and sex-matched controls were included. Among the 37 naltrexone-bupropion-treated patients, the mean weight loss was 9.2 ± 5.2% at 6 months and 9.7 ± 8.1% at 12 months, which were significantly more than in controls (p < 0.001). Improvements in the obesity-related parameters were observed in association with weight loss over 12 months. Ten patients (27.0%) discontinued naltrexone-bupropion due to side effects, mainly neurological and gastrointestinal manifestations, within the first 12 months.
Conclusion: We demonstrated real-world efficacy and safety of naltrexone-bupropion among Chinese patients with obesity.
{"title":"Real-world efficacy and safety of naltrexone-bupropion therapy in Chinese patients with obesity: A single-centre experience.","authors":"David Tak Wai Lui, Kimberly Hang Tsoi, Carol Ho Yi Fong, Nancy Su Jiang, Wing Sun Chow, Michele Mae Ann Yuen","doi":"10.1007/s12020-024-04029-2","DOIUrl":"10.1007/s12020-024-04029-2","url":null,"abstract":"<p><strong>Purpose: </strong>Naltrexone-bupropion (Contrave®) has shown efficacy and safety in large randomised controlled trials, predominantly comprising Caucasians. Data are limited in Asian populations. We carried out a retrospective matched cohort study of Chinese patients with obesity to evaluate the efficacy and safety of naltrexone-bupropion in real-world clinical practice.</p><p><strong>Methods: </strong>We performed a retrospective matched cohort study of Chinese patients with obesity managed in the Obesity Clinic of Queen Mary Hospital in Hong Kong between 1 January 2016 and 31 December 2020. Electronic health records of patients treated with naltrexone-bupropion were retrieved for body weight and height, obesity-related metabolic parameters, and adverse events over a 12-month period. Age- and sex-matched controls from the Obesity Clinic who were only on self-directed lifestyle management were identified for comparison of weight changes. General linear models were used to analyse the change in body weight over 12 months.</p><p><strong>Results: </strong>Thirty-seven patients treated with naltrexone-bupropion were included (mean age 42.2 ± 8.4 years, 54.1% men, baseline body mass index 37.3 ± 4.6 kg/m<sup>2</sup>), and 37 age- and sex-matched controls were included. Among the 37 naltrexone-bupropion-treated patients, the mean weight loss was 9.2 ± 5.2% at 6 months and 9.7 ± 8.1% at 12 months, which were significantly more than in controls (p < 0.001). Improvements in the obesity-related parameters were observed in association with weight loss over 12 months. Ten patients (27.0%) discontinued naltrexone-bupropion due to side effects, mainly neurological and gastrointestinal manifestations, within the first 12 months.</p><p><strong>Conclusion: </strong>We demonstrated real-world efficacy and safety of naltrexone-bupropion among Chinese patients with obesity.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"522-529"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377793","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}
Background: Age-specifically longitudinal associations and potential pathways between serum uric acid (SUA) and cardiovascular disease (CVD) remained unclear. This study aimed to explore SUA trajectories in different age populations and to determine their associations and potential pathways with incident CVD.
Methods: This prospective cohort included 41,367 participants from the Kailuan study, including 30,938 participants aged <55 years and 10,419 participants aged ≥55. The SUA trajectories during year 2006-2012 were identified by latent class growth models.
Results: Three SUA trajectories were identified in the overall, aged <55 and aged ≥55 years participants, as "low-stable" (51.9%, 54.4%, and 43.3%), "moderate-stable" (39.0%, 36.9%, and 45.6%), and "high-stable" (9.1%, 9.7%, and 11.1%), respectively. During a median follow-up of 6.75 years, incident CVD occurred in 2302 participants (5.56%). Overall, a high-stable trajectory was independently associated with a higher risk of CVD (hazard ratio [HR], 1.23; 95% [confidence interval], 1.06-1.42). Notably, the associations differed by age, a significant association was only observed in participants aged ≥55 years (HR, 1.29; 95% CI, 1.05-1.58), rather than those aged <55 years (HR, 1.08; 95% CI, 0.89-1.33). The addition of SUA trajectories to a baseline risk model for CVD improved the integrated discrimination improvement value (P < 0.05) and category-free net reclassification improvement value (P < 0.05). Bayesian network showed the conditional probability of high CVD risk associated with aging, elevated SUA trajectories, blood pressure, glucose, and inflammation was 15.5%.
Conclusions: High-stable SUA trajectories were independently associated with an elevated risk of CVD, which is mainly induced by hypertension, diabetes, and inflammation, especially in participants aged ≥55 years.
背景:血清尿酸(SUA)与心血管疾病(CVD)之间的年龄纵向关联和潜在途径仍不清楚。本研究旨在探索不同年龄人群的 SUA 变化轨迹,并确定其与心血管疾病事件的关联和潜在路径:方法:这项前瞻性队列研究纳入了开滦研究的 41367 名参与者,其中包括 30938 名不同年龄段的参与者:结论:在总体老年参与者中发现了三种 SUA 轨迹:高稳定 SUA 轨迹与心血管疾病风险升高独立相关,而心血管疾病风险升高主要由高血压、糖尿病和炎症诱发,尤其是在年龄≥55 岁的参与者中。
{"title":"Serum uric acid trajectories and the risk of cardiovascular disease: a longitudinal association and pathway analysis.","authors":"Lulu Chu, Xue Tian, Shuohua Chen, Xue Xia, Qin Xu, Yijun Zhang, Shouling Wu, Anxin Wang","doi":"10.1007/s12020-024-04038-1","DOIUrl":"10.1007/s12020-024-04038-1","url":null,"abstract":"<p><strong>Background: </strong>Age-specifically longitudinal associations and potential pathways between serum uric acid (SUA) and cardiovascular disease (CVD) remained unclear. This study aimed to explore SUA trajectories in different age populations and to determine their associations and potential pathways with incident CVD.</p><p><strong>Methods: </strong>This prospective cohort included 41,367 participants from the Kailuan study, including 30,938 participants aged <55 years and 10,419 participants aged ≥55. The SUA trajectories during year 2006-2012 were identified by latent class growth models.</p><p><strong>Results: </strong>Three SUA trajectories were identified in the overall, aged <55 and aged ≥55 years participants, as \"low-stable\" (51.9%, 54.4%, and 43.3%), \"moderate-stable\" (39.0%, 36.9%, and 45.6%), and \"high-stable\" (9.1%, 9.7%, and 11.1%), respectively. During a median follow-up of 6.75 years, incident CVD occurred in 2302 participants (5.56%). Overall, a high-stable trajectory was independently associated with a higher risk of CVD (hazard ratio [HR], 1.23; 95% [confidence interval], 1.06-1.42). Notably, the associations differed by age, a significant association was only observed in participants aged ≥55 years (HR, 1.29; 95% CI, 1.05-1.58), rather than those aged <55 years (HR, 1.08; 95% CI, 0.89-1.33). The addition of SUA trajectories to a baseline risk model for CVD improved the integrated discrimination improvement value (P < 0.05) and category-free net reclassification improvement value (P < 0.05). Bayesian network showed the conditional probability of high CVD risk associated with aging, elevated SUA trajectories, blood pressure, glucose, and inflammation was 15.5%.</p><p><strong>Conclusions: </strong>High-stable SUA trajectories were independently associated with an elevated risk of CVD, which is mainly induced by hypertension, diabetes, and inflammation, especially in participants aged ≥55 years.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"543-553"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-02DOI: 10.1007/s12020-024-04061-2
Alice Nervo, Matteo Ferrari, Elisa Vaccaro, Enrica Migliore, Giovanni Gruosso, Anna Roux, Alessandro Piovesan, Emanuela Arvat
Background: In differentiated/poorly differentiated (DTC/PDTC) or medullary thyroid cancer (MTC) treated with kinase inhibitors (KIs), additional treatments (ATs) can be performed in selected cases.
Methods: We retrospectively analysed all the ATs performed in our center in KI-treated TC patients, evaluating the subsequent KI modulation, the local PD in case of loco-regional procedure (LRP) and the AT-related complications. DTC/PDTC patients with or without progressive disease before the first AT (PD and NO PD GROUP, respectively) were analysed separately.
Results: In our center, 32 ATs (30 LRPs and 2 radioactive iodine treatments) were performed in 14 DTC/PDTC patients and 4 MTC subjects after the start of systemic therapy with lenvatinib or vandetanib (27 and 5 ATs, respectively). Brain was the most treated site (11/30 LRPs) and external beam radiation was the most employed LRP (18/30 LRPs). KIs dose reduction or discontinuation of KI therapy (at least transient) was performed after 50% of ATs in DTC/PDTC NO PD GROUP. The KI was maintained at the same dosage after 75% and 50% of the ATs performed in DTC/PDTC PD GROUP and MTC, respectively. During the follow-up, local PD was detected after 14 LRPs. Local progression-free survival (LPFS) was significantly shorter in DTC/PDTC PD GROUP in comparison to NO PD GROUP (12 month-LPFS 91.7% versus 15.2%); in patients with MTC, 12 month-LPFS was 50%. AT-related AEs were mostly G1-G2.
Conclusions: In selected DTC/PDTC without previous PD and treated with a multimodal strategy, local disease control is generally maintained regardless the KI dose modulation. In DTC/PDTC patients with previous limited PD and in MTC subjects, the choice of performing a LRP and continue the ongoing KI therapy must consider the risk of early local progression. AT-related AEs in KI treated patients were mild in most cases.
背景:在接受激酶抑制剂(KIs)治疗的分化型/低分化型(DTC/PDTC)或甲状腺髓样癌(MTC)患者中,可在选定病例中进行额外治疗(ATs):我们回顾性分析了本中心对KI治疗的TC患者实施的所有AT,评估了随后的KI调节、局部区域手术(LRP)的局部PD以及AT相关并发症。我们还分别分析了在首次AT前疾病有进展或无进展的DTC/PDTC患者(分别为有进展组和无进展组):在我们中心,14名DTC/PDTC患者和4名MTC患者在开始接受来伐替尼或凡德他尼全身治疗后,共进行了32次AT(30次LRP和2次放射性碘治疗)(分别为27次和5次)。脑部是接受治疗最多的部位(11/30 例 LRP),外照射是采用最多的 LRP(18/30 例 LRP)。在DTC/PDTC NO PD GROUP中,50%的AT发生后会减少KI剂量或停止KI治疗(至少是短暂的)。在 DTC/PDTC PD GROUP 和 MTC 分别进行了 75% 和 50% 的 AT 后,KI 的剂量保持不变。在随访期间,14 次 LRP 后检测到局部 PD。与无进展组相比,DTC/PDTC无进展组的局部无进展生存期(LPFS)明显较短(12个月LPFS为91.7%对15.2%);MTC患者的12个月LPFS为50%。AT相关的AE大多为G1-G2:对于既往没有帕金森病史且接受过多模式治疗的选定 DTC/PDTC 患者,无论 KI 剂量如何调整,一般都能维持局部疾病控制。对于既往有局限性前列腺增生的 DTC/PDTC 患者和 MTC 受试者,在选择是否进行 LRP 和继续进行 KI 治疗时,必须考虑早期局部进展的风险。接受 KI 治疗的患者中与 AT 相关的 AE 在大多数情况下都很轻微。
{"title":"Tailored management of advanced thyroid cancer patients treated with lenvatinib or vandetanib: the role of a multimodal approach.","authors":"Alice Nervo, Matteo Ferrari, Elisa Vaccaro, Enrica Migliore, Giovanni Gruosso, Anna Roux, Alessandro Piovesan, Emanuela Arvat","doi":"10.1007/s12020-024-04061-2","DOIUrl":"10.1007/s12020-024-04061-2","url":null,"abstract":"<p><strong>Background: </strong>In differentiated/poorly differentiated (DTC/PDTC) or medullary thyroid cancer (MTC) treated with kinase inhibitors (KIs), additional treatments (ATs) can be performed in selected cases.</p><p><strong>Methods: </strong>We retrospectively analysed all the ATs performed in our center in KI-treated TC patients, evaluating the subsequent KI modulation, the local PD in case of loco-regional procedure (LRP) and the AT-related complications. DTC/PDTC patients with or without progressive disease before the first AT (PD and NO PD GROUP, respectively) were analysed separately.</p><p><strong>Results: </strong>In our center, 32 ATs (30 LRPs and 2 radioactive iodine treatments) were performed in 14 DTC/PDTC patients and 4 MTC subjects after the start of systemic therapy with lenvatinib or vandetanib (27 and 5 ATs, respectively). Brain was the most treated site (11/30 LRPs) and external beam radiation was the most employed LRP (18/30 LRPs). KIs dose reduction or discontinuation of KI therapy (at least transient) was performed after 50% of ATs in DTC/PDTC NO PD GROUP. The KI was maintained at the same dosage after 75% and 50% of the ATs performed in DTC/PDTC PD GROUP and MTC, respectively. During the follow-up, local PD was detected after 14 LRPs. Local progression-free survival (LPFS) was significantly shorter in DTC/PDTC PD GROUP in comparison to NO PD GROUP (12 month-LPFS 91.7% versus 15.2%); in patients with MTC, 12 month-LPFS was 50%. AT-related AEs were mostly G1-G2.</p><p><strong>Conclusions: </strong>In selected DTC/PDTC without previous PD and treated with a multimodal strategy, local disease control is generally maintained regardless the KI dose modulation. In DTC/PDTC patients with previous limited PD and in MTC subjects, the choice of performing a LRP and continue the ongoing KI therapy must consider the risk of early local progression. AT-related AEs in KI treated patients were mild in most cases.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"724-733"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-10-09DOI: 10.1007/s12020-024-04067-w
Yang Chen, Yaqin Deng, Minjia Wu, Peixuan Ma, Wen Pan, Weiqi Chen, Lina Zhao, Xiaowei Huang
Objective: We conducted a systematic review and meta-analysis of observational studies that assessed the relationship between pesticides exposure and type 2 diabetes. We also examined the presence of heterogeneity and biases across the available studies.
Methods: We conducted a comprehensive literature search of peer-reviewed studies published from 2011 to 2023, without language limitations. A random-effects model was employed to calculate the overall odds ratio (OR) and its corresponding 95% confidence interval (CI).
Results: We included 19 studies (n = 12 case-control and n = 7 cross-sectional) for a total of 45,813 participants in our analysis. Our findings revealed a notable correlation between pesticide exposure and type 2 diabetes (non-specific definition) when not limiting pesticide types (OR: 1.19, 95% CI: 1.11-1.28). Subgroup analysis identified associations between pyrethroid (OR: 1.17, 95% CI: 1.05-1.30) and type 2 diabetes, as well as between organochlorine (OR: 1.26, 95% CI: 1.11-1.43) and type 2 diabetes. However, no statistically significant association was observed between herbicide exposure and the onset of type 2 diabetes (OR: 1.26, 95% CI: 0.91-1.75). In the elderly group, pesticide exposure significantly heightened the risk of type 2 diabetes (OR: 1.25, 95% CI: 1.14-1.38), with no statistically significant heterogeneity among studies (I2 = 14.2%, p = 0.323).
Conclusions: Pesticide (organochlorine and pyrethroid) exposure constitutes a risk factor for type 2 diabetes.
{"title":"Impact of pesticides exposure and type 2 diabetes risk: a systematic review and meta-analysis.","authors":"Yang Chen, Yaqin Deng, Minjia Wu, Peixuan Ma, Wen Pan, Weiqi Chen, Lina Zhao, Xiaowei Huang","doi":"10.1007/s12020-024-04067-w","DOIUrl":"10.1007/s12020-024-04067-w","url":null,"abstract":"<p><strong>Objective: </strong>We conducted a systematic review and meta-analysis of observational studies that assessed the relationship between pesticides exposure and type 2 diabetes. We also examined the presence of heterogeneity and biases across the available studies.</p><p><strong>Methods: </strong>We conducted a comprehensive literature search of peer-reviewed studies published from 2011 to 2023, without language limitations. A random-effects model was employed to calculate the overall odds ratio (OR) and its corresponding 95% confidence interval (CI).</p><p><strong>Results: </strong>We included 19 studies (n = 12 case-control and n = 7 cross-sectional) for a total of 45,813 participants in our analysis. Our findings revealed a notable correlation between pesticide exposure and type 2 diabetes (non-specific definition) when not limiting pesticide types (OR: 1.19, 95% CI: 1.11-1.28). Subgroup analysis identified associations between pyrethroid (OR: 1.17, 95% CI: 1.05-1.30) and type 2 diabetes, as well as between organochlorine (OR: 1.26, 95% CI: 1.11-1.43) and type 2 diabetes. However, no statistically significant association was observed between herbicide exposure and the onset of type 2 diabetes (OR: 1.26, 95% CI: 0.91-1.75). In the elderly group, pesticide exposure significantly heightened the risk of type 2 diabetes (OR: 1.25, 95% CI: 1.14-1.38), with no statistically significant heterogeneity among studies (I<sup>2</sup> = 14.2%, p = 0.323).</p><p><strong>Conclusions: </strong>Pesticide (organochlorine and pyrethroid) exposure constitutes a risk factor for type 2 diabetes.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"448-458"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aims to investigate the factors that influence the absorption of the ablation zone in patients with papillary thyroid microcarcinoma (PTMC) following microwave ablation (MWA) and construct a nomogram for predicting the absorption of the ablation zone.
Methods: Data from 150 patients with 187 PTMCs who received MWA between April 2020 and April 2023 were analyzed. PTMCs were randomly divided into training and validation sets in a 7:3 ratio. Univariable and multivariable analyses of Cox regression were utilized to identify the independent variables associated with the absorption of the ablation zone in PTMC post-MWA, and a nomogram was established. The discrimination and calibration performance of the nomogram was assessed using the time-dependent receiver operating characteristic curves and calibration curves.
Results: At 12 months post-MWA, a 53% proportion of complete disappearance of the ablation zone was observed. Energy delivered per milliliter of volume measured in contrast-enhanced ultrasound (CEUS) mode immediately post-MWA (Edv) and the CEUS margin at 1-month post-WMA were identified as independently correlated with the ablation zone absorption post-MWA (P = 0.001, P < 0.001 respectively). A nomogram incorporating these two factors was constructed. The areas under the receiver operating characteristic curve were all above 0.78 in the training and validation sets.
Conclusion: Edv and the CEUS margin at 1-month post-MWA were found to be significantly associated with complete absorption of the ablation zone in PTMC patients following MWA. The established nomogram can assist practitioners in formulating more appropriate ablation strategies and provide a clinical basis for explaining the recovery status to patients.
{"title":"Analysis and prediction of ablation zone absorption in papillary thyroid microcarcinoma undergoing microwave ablation.","authors":"Chenyang Jin, Xiaofeng Wu, Kairen Zhang, Ying Song, Yingying Zhao, Liping Xu, Ying Huang, Lihong Zhang, Mengyao Sun, Mengshang Hu, Fenglin Dong","doi":"10.1007/s12020-024-04049-y","DOIUrl":"10.1007/s12020-024-04049-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to investigate the factors that influence the absorption of the ablation zone in patients with papillary thyroid microcarcinoma (PTMC) following microwave ablation (MWA) and construct a nomogram for predicting the absorption of the ablation zone.</p><p><strong>Methods: </strong>Data from 150 patients with 187 PTMCs who received MWA between April 2020 and April 2023 were analyzed. PTMCs were randomly divided into training and validation sets in a 7:3 ratio. Univariable and multivariable analyses of Cox regression were utilized to identify the independent variables associated with the absorption of the ablation zone in PTMC post-MWA, and a nomogram was established. The discrimination and calibration performance of the nomogram was assessed using the time-dependent receiver operating characteristic curves and calibration curves.</p><p><strong>Results: </strong>At 12 months post-MWA, a 53% proportion of complete disappearance of the ablation zone was observed. Energy delivered per milliliter of volume measured in contrast-enhanced ultrasound (CEUS) mode immediately post-MWA (Edv) and the CEUS margin at 1-month post-WMA were identified as independently correlated with the ablation zone absorption post-MWA (P = 0.001, P < 0.001 respectively). A nomogram incorporating these two factors was constructed. The areas under the receiver operating characteristic curve were all above 0.78 in the training and validation sets.</p><p><strong>Conclusion: </strong>Edv and the CEUS margin at 1-month post-MWA were found to be significantly associated with complete absorption of the ablation zone in PTMC patients following MWA. The established nomogram can assist practitioners in formulating more appropriate ablation strategies and provide a clinical basis for explaining the recovery status to patients.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"707-717"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01Epub Date: 2024-09-26DOI: 10.1007/s12020-024-04027-4
Pasqualino Malandrino, Dario Tumino, Marco Russo, Rosario Le Moli, Antonio Prinzi, Tommaso Piticchio, Francesco Frasca
Background: Surgery stands as the cornerstone treatment for differentiated thyroid cancer (DTC). After surgery, radioactive iodine (RAI) administration is primarily recommended for high-risk patients and commonly employed to address residual disease or mitigate the risk of recurrence. However, the optimal application of RAI in cases categorized as low to intermediate risk is still uncertain. This study aims to assess the indication of post-surgical RAI treatment specifically in patients diagnosed with DTC falling within the low to intermediate risk category for recurrent disease.
Methods: retrospective analysis of consecutive patients with DTC falling within the low to intermediate risk category for recurrence and diagnosed between 2009-2015. Patients were categorized into either treated or untreated with RAI. Treatment effect was assessed by the inverse-probability weighted regression adjustment (IPWRA), by balancing the distribution of factors influencing outcome and treatment assignment.
Results: after surgery, 328 patients (69.9%) were treated with RAI while 141 (30.1%) were left untreated. Across the entire cohort, 44 individuals (9.4%) displayed biochemical or structural disease after a median time of 17.5 months following diagnosis. Recurrent disease was more prevalent in patients who underwent RAI treatment compared to those untreated (12.5% vs 2.1%, respectively, p < 0.001). Factors independently associated with recurrent disease, identified through multivariate logistic regression analysis, included lymph node metastases (pN1) (OR = 4.07; 95% CI 1.84-8.97), male sex (OR = 2.71; 95% CI 1.31-5.59), tumor size (OR = 1.03; 95% CI 1.00-1.06), and microscopic extrathyroidal extension (OR = 2.36; 95% CI 1.15-4.81). IPWRA analysis revealed that the occurrence of recurrent disease was 9.6% (95% CI = 6.3-12.9) in RAI-treated patients and 15.9% (95% CI = 11.1-20.71) in untreated patients (p = 0.021). As a consequence, if all patients underwent RAI treatment, the estimated risk of recurrence would be reduced by 42% (RR = 0.58; 95% CI = 0.35-0.91, p = 0.018). The greatest benefit was observed in patients with 2 intermediate risk factors.
Conclusions: These results suggest that treatment with RAI in low to intermediate DTC can reduce the risk of recurrence in selected patients. However, definitive answers regarding whether to consider RAI therapy for this category of patients can only be attained through prospective clinical trials. Up to date these results recommend a meticulous assessment of tumor characteristics at diagnosis to guide the decision regarding RAI administration.
背景:手术是分化型甲状腺癌(DTC)的基础治疗方法。手术后,放射性碘(RAI)主要推荐用于高危患者,通常用于治疗残留疾病或降低复发风险。然而,在中低风险病例中应用 RAI 的最佳方案仍不确定。本研究旨在评估手术后 RAI 治疗的适应症,特别是确诊为复发疾病中低等风险类别的 DTC 患者。方法:对 2009-2015 年间确诊为复发疾病中低等风险类别的 DTC 连续患者进行回顾性分析。患者被分为接受 RAI 治疗和未接受 RAI 治疗两种。治疗效果通过反概率加权回归调整(IPWRA)进行评估,方法是平衡影响结果和治疗分配的因素分布。在整个队列中,有 44 人(9.4%)在确诊后的中位时间 17.5 个月后出现生化或结构性疾病。与未接受 RAI 治疗的患者相比,接受 RAI 治疗的患者复发率更高(分别为 12.5% 对 2.1%,P这些结果表明,对中低度 DTC 患者进行 RAI 治疗可降低特定患者的复发风险。然而,是否考虑对这类患者进行 RAI 治疗,只有通过前瞻性临床试验才能得出明确答案。迄今为止,这些结果都建议在诊断时对肿瘤特征进行细致评估,以指导 RAI 治疗的决策。
{"title":"Consider or not consider: the unsolved question on the use of radioactive iodine for differentiated thyroid cancer with low to intermediate risk of recurrence.","authors":"Pasqualino Malandrino, Dario Tumino, Marco Russo, Rosario Le Moli, Antonio Prinzi, Tommaso Piticchio, Francesco Frasca","doi":"10.1007/s12020-024-04027-4","DOIUrl":"10.1007/s12020-024-04027-4","url":null,"abstract":"<p><strong>Background: </strong>Surgery stands as the cornerstone treatment for differentiated thyroid cancer (DTC). After surgery, radioactive iodine (RAI) administration is primarily recommended for high-risk patients and commonly employed to address residual disease or mitigate the risk of recurrence. However, the optimal application of RAI in cases categorized as low to intermediate risk is still uncertain. This study aims to assess the indication of post-surgical RAI treatment specifically in patients diagnosed with DTC falling within the low to intermediate risk category for recurrent disease.</p><p><strong>Methods: </strong>retrospective analysis of consecutive patients with DTC falling within the low to intermediate risk category for recurrence and diagnosed between 2009-2015. Patients were categorized into either treated or untreated with RAI. Treatment effect was assessed by the inverse-probability weighted regression adjustment (IPWRA), by balancing the distribution of factors influencing outcome and treatment assignment.</p><p><strong>Results: </strong>after surgery, 328 patients (69.9%) were treated with RAI while 141 (30.1%) were left untreated. Across the entire cohort, 44 individuals (9.4%) displayed biochemical or structural disease after a median time of 17.5 months following diagnosis. Recurrent disease was more prevalent in patients who underwent RAI treatment compared to those untreated (12.5% vs 2.1%, respectively, p < 0.001). Factors independently associated with recurrent disease, identified through multivariate logistic regression analysis, included lymph node metastases (pN1) (OR = 4.07; 95% CI 1.84-8.97), male sex (OR = 2.71; 95% CI 1.31-5.59), tumor size (OR = 1.03; 95% CI 1.00-1.06), and microscopic extrathyroidal extension (OR = 2.36; 95% CI 1.15-4.81). IPWRA analysis revealed that the occurrence of recurrent disease was 9.6% (95% CI = 6.3-12.9) in RAI-treated patients and 15.9% (95% CI = 11.1-20.71) in untreated patients (p = 0.021). As a consequence, if all patients underwent RAI treatment, the estimated risk of recurrence would be reduced by 42% (RR = 0.58; 95% CI = 0.35-0.91, p = 0.018). The greatest benefit was observed in patients with 2 intermediate risk factors.</p><p><strong>Conclusions: </strong>These results suggest that treatment with RAI in low to intermediate DTC can reduce the risk of recurrence in selected patients. However, definitive answers regarding whether to consider RAI therapy for this category of patients can only be attained through prospective clinical trials. Up to date these results recommend a meticulous assessment of tumor characteristics at diagnosis to guide the decision regarding RAI administration.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":"658-666"},"PeriodicalIF":3.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343810","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}
Pub Date : 2025-01-30DOI: 10.1007/s12020-025-04162-6
Lorenzo Iughetti, Franco Antoniazzi, Claudia Giavoli, Simonetta Bellone, Tommaso Aversa, Laura Guazzarotti, Maria Elisabeth Street, Emanuele Miraglia Del Giudice, Luca Persani, Gabriella Pozzobon, Letizia Ragusa, Stefano Stagi, Gianluca Tornese, Clara Zecchino, Chiara Mameli, Emiliano Zecchi, Paolo Fedeli, Markus Zabransky, Laura Lucaccioni, Stefano Zucchini
{"title":"Correction to: Long-term safety and effectiveness of a somatropin biosimilar (Omnitrope®) in children requiring growth hormone therapy: analysis of final data of Italian patients enrolled in the PATRO children study.","authors":"Lorenzo Iughetti, Franco Antoniazzi, Claudia Giavoli, Simonetta Bellone, Tommaso Aversa, Laura Guazzarotti, Maria Elisabeth Street, Emanuele Miraglia Del Giudice, Luca Persani, Gabriella Pozzobon, Letizia Ragusa, Stefano Stagi, Gianluca Tornese, Clara Zecchino, Chiara Mameli, Emiliano Zecchi, Paolo Fedeli, Markus Zabransky, Laura Lucaccioni, Stefano Zucchini","doi":"10.1007/s12020-025-04162-6","DOIUrl":"https://doi.org/10.1007/s12020-025-04162-6","url":null,"abstract":"","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-30DOI: 10.1007/s12020-025-04181-3
Andromachi Vryonidou, Maria Mizamtsidi, Eleni Palioura, Nikolaos Kalogeris, Evangeline Vassilatou, Dimitrios Ioannidis, Vicky Loi, Stavroula A Paschou
Purpose: Several studies suggest a linkage between PCOS and autoimmunity with a high frequency of chronic autoimmune thyroiditis (AIT) reported in PCOS patients, however, this subject remains controversial. The aim of this study was to investigate the prevalence of AIT in PCOS women and identify parameters that would serve as independent predictors of AIT.
Methods: Two hundred fifty seven (257) PCOS patients according to the NIH criteria and one hundred forty three (143) controls, women with normal menstrual cycles and without clinical or biochemical hyperandrogenism, were recruited for the study. Anthropometric characteristics and a complete family history for AIT were recorded. Thyroid hormones, antithyroid antibodies, androgen, glucose and insulin levels were measured. Thyroid gland structure was evaluated by ultrasound scan.
Results: Patients and controls did not differ in age, BMI as well as genetic predisposition for AIT (p > 0.05). Women with PCOS presented higher levels of androgens and HOMA-IR index, as expected. AIT prevalence did not differ between women with PCOS and controls (4.8 vs 9.3%, p = 0.13). However, the subgroup of PCOS patients with AIT presented a significantly stronger predisposition for AIT (33.3 vs 4.7%, p = 0.004) compared to patients without AIT. In a multivariate regression model, a positive family history of AIT was proved to be the strongest independent predictor of AIT in the PCOS group (OR 7.06, 95% CI 1.04-47.79, R2 = 0.39).
Conclusion: The prevalence of AIT in the PCOS patients does not differ from the general population when family predisposition to AIT is taken into account.
{"title":"The prevalence of autoimmune thyroiditis is not increased in women with polycystic ovary syndrome after adjustment for family predisposition.","authors":"Andromachi Vryonidou, Maria Mizamtsidi, Eleni Palioura, Nikolaos Kalogeris, Evangeline Vassilatou, Dimitrios Ioannidis, Vicky Loi, Stavroula A Paschou","doi":"10.1007/s12020-025-04181-3","DOIUrl":"https://doi.org/10.1007/s12020-025-04181-3","url":null,"abstract":"<p><strong>Purpose: </strong>Several studies suggest a linkage between PCOS and autoimmunity with a high frequency of chronic autoimmune thyroiditis (AIT) reported in PCOS patients, however, this subject remains controversial. The aim of this study was to investigate the prevalence of AIT in PCOS women and identify parameters that would serve as independent predictors of AIT.</p><p><strong>Methods: </strong>Two hundred fifty seven (257) PCOS patients according to the NIH criteria and one hundred forty three (143) controls, women with normal menstrual cycles and without clinical or biochemical hyperandrogenism, were recruited for the study. Anthropometric characteristics and a complete family history for AIT were recorded. Thyroid hormones, antithyroid antibodies, androgen, glucose and insulin levels were measured. Thyroid gland structure was evaluated by ultrasound scan.</p><p><strong>Results: </strong>Patients and controls did not differ in age, BMI as well as genetic predisposition for AIT (p > 0.05). Women with PCOS presented higher levels of androgens and HOMA-IR index, as expected. AIT prevalence did not differ between women with PCOS and controls (4.8 vs 9.3%, p = 0.13). However, the subgroup of PCOS patients with AIT presented a significantly stronger predisposition for AIT (33.3 vs 4.7%, p = 0.004) compared to patients without AIT. In a multivariate regression model, a positive family history of AIT was proved to be the strongest independent predictor of AIT in the PCOS group (OR 7.06, 95% CI 1.04-47.79, R<sup>2</sup> = 0.39).</p><p><strong>Conclusion: </strong>The prevalence of AIT in the PCOS patients does not differ from the general population when family predisposition to AIT is taken into account.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-29DOI: 10.1007/s12020-025-04175-1
Banalata Mohanty, Brijesh Kumar Mishra
Purpose: Chronic exposure to synthetic glucocorticoids/GCs, widely in use to treat many diseases, may compromise the hypothalamic-pituitary-adrenal/HPA axis leading to a condition of adrenal insufficiency/AI. This study demonstrates the efficacy of the melatonin/MEL in amelioration of chronic dexamethasone (DEX)-induced AI.
Methods: Mice (Parkes Strain/Male/8 weeks old/30-33 g) were maintained in four groups (10 mice/group) for 30 days: Group 1/Control received intraperitoneal (i.p) vehicle (alcoholic 0.9% normal saline); Group II/DEX (400 µg/kg BW/day/i.p), Group III/(DEX + MEL 750 µg/kg BW/day/subcutaneous), and Group IV received only MEL. Adrenal, pituitary, and blood samples were collected from six mice/groups. Four mice/groups were subjected to the Lipopolysaccharide (LPS) challenge. Adrenal histology, ACTH immunohistochemistry, and plasma ACTH and corticosterone/CORT levels were measured.
Results: DEX exposure suppressed the pituitary ACTH expression significantly from control as revealed by morphometry and circulating hormones (Density, p < 0.01; size, immunointensity, plasma ACTH, and CORT; p < 0.001). Increased adrenal histopathology indicated probable AI. MEL co-supplementation significantly increased the corticotropes' density (p < 0.05), size (p < 0.001), immunointensity (<0.01), and plasma level of ACTH (p < 0.01) compared to the DEX group. The adreno-cortical width, zona fasciculata cell density and size, and the plasma CORT level (p < 0.001) were also significantly increased. The enhanced CORT response of the HPA axis in the DEX + MEL group compared to the DEX group on the LPS challenge provides support for the MEL restoration of the HPA axis functioning.
Conclusion: Further research on the MEL modulation of the HPA axis may support its role in preventing AI.
{"title":"Melatonin modulation of the chronic dexamethasone-induced adrenal insufficiency.","authors":"Banalata Mohanty, Brijesh Kumar Mishra","doi":"10.1007/s12020-025-04175-1","DOIUrl":"https://doi.org/10.1007/s12020-025-04175-1","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic exposure to synthetic glucocorticoids/GCs, widely in use to treat many diseases, may compromise the hypothalamic-pituitary-adrenal/HPA axis leading to a condition of adrenal insufficiency/AI. This study demonstrates the efficacy of the melatonin/MEL in amelioration of chronic dexamethasone (DEX)-induced AI.</p><p><strong>Methods: </strong>Mice (Parkes Strain/Male/8 weeks old/30-33 g) were maintained in four groups (10 mice/group) for 30 days: Group 1/Control received intraperitoneal (i.p) vehicle (alcoholic 0.9% normal saline); Group II/DEX (400 µg/kg BW/day/i.p), Group III/(DEX + MEL 750 µg/kg BW/day/subcutaneous), and Group IV received only MEL. Adrenal, pituitary, and blood samples were collected from six mice/groups. Four mice/groups were subjected to the Lipopolysaccharide (LPS) challenge. Adrenal histology, ACTH immunohistochemistry, and plasma ACTH and corticosterone/CORT levels were measured.</p><p><strong>Results: </strong>DEX exposure suppressed the pituitary ACTH expression significantly from control as revealed by morphometry and circulating hormones (Density, p < 0.01; size, immunointensity, plasma ACTH, and CORT; p < 0.001). Increased adrenal histopathology indicated probable AI. MEL co-supplementation significantly increased the corticotropes' density (p < 0.05), size (p < 0.001), immunointensity (<0.01), and plasma level of ACTH (p < 0.01) compared to the DEX group. The adreno-cortical width, zona fasciculata cell density and size, and the plasma CORT level (p < 0.001) were also significantly increased. The enhanced CORT response of the HPA axis in the DEX + MEL group compared to the DEX group on the LPS challenge provides support for the MEL restoration of the HPA axis functioning.</p><p><strong>Conclusion: </strong>Further research on the MEL modulation of the HPA axis may support its role in preventing AI.</p>","PeriodicalId":11572,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}