Endocrine Connections最新文献

Introduction: Gestational diabetes mellitus (GDM) significantly affects pregnancy outcomes. Therefore, it is crucial to develop prediction models since they can guide timely interventions to reduce the incidence of GDM and its associated adverse effects.

Methods: A total of 554 pregnant women were selected and their sociodemographic characteristics, clinical data and dietary data were collected. Dietary data were investigated by a validated semi-quantitative food frequency questionnaire (FFQ). We applied random forest mean decrease impurity for feature selection and the models are built using logistic regression, XGBoost, and LightGBM algorithms. The prediction performance of different models was compared by accuracy, sensitivity, specificity, area under curve (AUC) and Hosmer-Lemeshow test.

Results: Blood glucose, age, pre-pregnancy body mass index (BMI), triglycerides and high-density lipoprotein cholesterol (HDL) were the top five features according to the feature selection. Among the three algorithms, XGBoost performed best with an AUC of 0.788, LightGBM came second (AUC = 0.749), and logistic regression performed the worst (AUC = 0.712). In addition, XGBoost and LightGBM both achieved a fairly good performance when dietary information was included, surpassing their performance on the non-dietary dataset (0.788 vs 0.718 in XGBoost; 0.749 vs 0.726 in LightGBM).

Conclusion: XGBoost and LightGBM algorithms outperform logistic regression in predicting GDM among Chinese pregnant women. In addition, dietary data may have a positive effect on improving model performance, which deserves more in-depth investigation with larger sample size.

Objective: Serum prolactin measurements are important in the differential diagnosis of pituitary masses and subfertility. We observed discrepancies in serum prolactin levels in several patients measured with different immunoassays. Despite differences in assay results, the reference intervals (RIs) derived by the manufacturers were similar. In this study, we aimed to investigate prolactin assay differences and to re-establish RIs for different prolactin immunoassays.

Methods: For the assay comparison, serum samples were collected from men and women visiting the Amsterdam UMC hospital. Prolactin levels were measured using the AtellicaTM IM analyzer (Siemens Healthineers) and the Cobas (Roche Diagnostics) immunoassay. RIs for prolactin were re-established for men, premenopausal women, and postmenopausal women for both the Atellica and Cobas immunoassay.

Results: Prolactin levels measured using the Cobas immunoassay were 1.75 times higher than those measured using the Atellica immunoassay. The re-established RIs for Atellica and Cobas confirmed these findings and were <0.32 U/L; <0.55 U/L for men; <0.64 U/L; <0.86 U/L for premenopausal women, and <0.31 U/L; <0.59 U/L for postmenopausal women, respectively, for Atellica and Cobas assays. The re-established RIs of the Atellica assay matched the current and manufacturer RIs, whereas those for Cobas differed substantially.

Conclusions: Prolactin levels are assay-dependent, and the re-established RIs are different for the Atellica and Cobas assays. We recommend that laboratory specialists and manufacturers periodically review prolactin assay RIs, as incorrect RIs can lead to misinterpretation of prolactin levels and unnecessary referrals and further laboratory testing, as we have experienced.

Plain language summary: We showed that the results of different prolactin tests disagree by 75%, which hinders correct interpretation. Thus, we established test-specific prolactin normal values. By being aware of test differences and using test-specific normal values, one can ensure correct interpretation and prevent unnecessary referrals and concern.

Background: Transforming growth factor beta receptor III (TGFBR3) has been shown to play a tumor-suppressive role in a variety of cancers. However, its role in papillary thyroid cancer (PTC) remains unknown.

Method: TGFBR3 expression levels in PTC were analyzed utilizing The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. Edu, wound healing, and Transwell assays were used to evaluate cell proliferation, migration, and invasion. Transcriptome sequencing, quantitative real-time reverse transcription-polymerase chain reaction (qRT-PCR), and Western blotting were used to detect the underlying mechanism of TGFBR3 in PTC progression.

Result: This study demonstrated that TGFBR3 expression was significantly down-regulated in PTC compared to normal thyroid tissues. Low expression of TGFBR3 was associated with poor prognosis of patients with PTC. Furthermore, TGFBR3 expression positively correlated with thyroid differentiation score. In investigating the biological impact of TGFBR3 overexpression in PTC cell lines, we found that the proliferation, migration, and invasion of PTC cells were significantly inhibited in response to TGFBR3 overexpression. Moreover, we also demonstrated that overexpression of TGFBR3 inhibited the PI3K/AKT pathway and epithelial-mesenchymal transformation processes. Lastly, TGFBR3 expression was found to be involved in tumor immune infiltration, highlighting its potential influence on immune dynamics within the tumor microenvironment in PTC.

Conclusion: TGFBR3 plays a tumor-suppressive role in PTC progression by inhibiting the PI3K/AKT pathway and epithelial mesenchymal transformation.

Objectives: To investigate the utility and effectiveness of a school outreach programme in areas of lower socioeconomic status to improve understanding of common endocrine topics and the medical profession.

Methods: Two secondary school outreach sessions were conducted in July 2022. Students were invited to attend lectures delivered by medical professionals and engage in poster-making sessions using the knowledge they had gained throughout the day. Participants completed anonymised pre- and post-session surveys. Outcomes were identified using Kirkpatrick's training evaluation model. Self-reported perceptions and beliefs (Kirkpatrick's level 2a) were compared using chi-square tests. Thematic analysis of team-led poster presentations was performed.

Results: Of the 254 participants included, the response rates of pre- and post-session questionnaires were 75.6% and 56.2%, respectively. The outreach day increased students' understanding of obesity and diabetes, polycystic ovary syndrome, and Health Technology. The most well-received activities from the outreach day were voted to be the poster challenge (43.4%) and poster presentation (14.7%). Following the session, there was a trend towards an increased understanding of medical careers and interest in pursuing a medical career, although these did not reach statistical significance.

Conclusions: Outreach programmes could be a practical and effective approach to engaging prospective medical applicants from areas of lower socioeconomic status. Further studies are required to expand outreach programmes and investigate the efficacy of school engagement programmes.

Purpose: This study aimed to investigate the relationship between magnetic resonance image (MRI) features and the immunohistochemical subtypes of pituitary microadenomas (PMAs) characterized by location and growth pattern.

Materials and methods: A double-center, retrospective review of MRI characteristics was conducted in 57 PMA cases recorded from February 2014 to September 2023, identified based on the 2017 World Health Organization classification of pituitary gland tumors. The geometric center of the tumor was defined, and the possibility of PMA vertical or lateral growth patterns was evaluated according to the ratio of maximum diameter between the X and Y axes.

Results: Among the PMAs, somatotroph adenomas (STAs) significantly frequented the lateral-anteroinferior portion of the pituitary gland (P = 0.036). Lactotroph adenomas (LTAs) showed a significant locational preference for the lateral-posteroinferior portion (P = 0.037), and gonadotroph adenomas (GTAs) were predominantly located in the central-anteroinferior portion (P = 0.022). Furthermore, PMAs in the suprasellar portion exhibited vertical extension with statistical significance (P = 0.0).

Conclusion: In our cohort, micro-STAs were predominantly located in the lateral-anteroinferior portion of the pituitary gland, micro-LTAs in the lateral-posteroinferior portion, and micro-GTAs in the central-anteroinferior portion. The growth pattern of PMAs was highly correlated with their vertical position instead of their immunohistochemical subtypes. Therefore, MRI shows potential in differentiating partial PMA subgroups, especially cases within the silent groups.

Background: Evidence has demonstrated that visceral fat area (VFA) and subcutaneous fat area (SFA) have different influences on cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (T2DM). We aimed to investigate the relationship between the visceral fat area (VFA), the subcutaneous fat area (SFA) ratio (V/S), and carotid atherosclerosis (CAS) in patients with T2DM.

Methods: From January 2018 to May 2023, 1838 patients with T2DM admitted to the National Metabolic Management Centre in our hospital were assigned to two groups based on comorbid CAS. Dual bioelectrical impedance analysis was used to measure the VAF and SFA, and the V/S was calculated. Patient characteristics and serum biochemical indices were compared between groups. Factors influencing comorbid CAS were determined, and correlations between V/S and other clinical indices were analyzed.

Results: The group with comorbid CAS included 858 individuals and 980 without comorbid CAS. Those with comorbid CAS were older and had a longer disease duration, more significant systolic blood pressure, and greater V/S. The proportions of patients with comorbid hypertension increased significantly with the V/S ratio. The V/S ratio positively correlated with triglyceride (TG), low-density lipoprotein cholesterol levels, and waist circumference. According to binary logistic regression analysis, V/S was an independent risk factor for CAS.

Conclusion: Elevated V/S is an independent risk factor for CAS in patients with T2DM.

Background: a high prevalence (40-75%) of organic brain lesions in boys with central precocious puberty (CPP) has been reported.

Objectives: to evaluate the causes of CPP in a large cohort of males and to identify possible predictive factors for organic brain lesions in males.

Design: an observational study was conducted in 102 otherwise healthy boys with CPP diagnosed from 1998 to 2023 in a single tertiary center.

Methods: all boys underwent a thorough clinical, endocrine and neuroimaging assessment with a detailed evaluation of the pituitary region.

Results: organic CPP were found in only 8/102 children (7.8%). Children with brain tumors were younger than 8 years, had no family history positive for precocious puberty and maternal menarche occurred at an age significantly more advanced than in children with idiopathic CPP. Headache was reported at diagnosis in 7/8 children with brain tumors. A progressive increase in the occurrence of idiopathic CPP in males has been observed in the last two decades with a peak of new diagnoses during the pandemic lockdown.

Conclusions: our findings indicate that the prevalence of pathological brain lesions in boys with CPP is considerably lower than previously reported thus making the diagnosis less alarming. Age younger than eight years, presence of neurological symptoms, family history negative for precocious puberty in first degree relatives and age of maternal menarche older than 11 years raise suspicion of organic CPP and should lead to prompt neuroimaging.

Aims and background: Curcumin's function in affecting cancer metabolic reprogramming remains poorly understood. Herein, we aimed to elucidate a novel link between Curcumin and the glucose uptake metabolism and glucose transporters (GLUTs) status in SW1736 cell line derived from anaplastic thyroid cancer.

Materials and methods: TheMTT test and flow cytometry was employed to test cell viability and cell death. For glucose uptake detection, ''GOD-PAP'' enzymatic colorimetric assay was applied to measure the direct glucose levels inside of the cells. Determination of GLUT1 and GLUT3 mRNA and protein expression in SW1736 cells was performed by qRT-PCR and western blotting. Also, the scratch wound healing assay was conducted for cell migration.

Results: The data indicated that Curcumin-induced cell death is independent of apoptosis in this type of thyroid cancer cell line. Furthermore, significantly reduced GLUT1 and GLUT3 expression was observed after treatment with Curcumin, resulting in the inhibition of glucose uptake (p < 0.05). Scratch assay indicated the inhibition of cell migration in SW1736 cells treated by Curcumin (p < 0.05).

Conclusion: It can be concluded that GLUTs as metabolic targets can be blocked specifically by Curcumin for thyroid cancer prevention. Curcumin, as a promising anti-cancer agent, inhibits the growth of SW1736 anaplastic thyroid cancer cell line by regulating glucose uptake pathway and cell death. Altogether, these results suggest that the glucose pathway may be an important target for therapeutic intervention to sensitize tumor cells to cell death process by inhibition of glucose transporters.

Introduction: The aim of this study was to define functional and anatomical pituitary disease at the time of presentation following immune checkpoint inhibitor (ICI) therapy and to describe any changes in pituitary function over time.

Methods: We conducted a retrospective observational audit of patients on ICI therapy at our centre between January 2013 and September 2023. We reviewed all patients on ICI therapy under the care of the oncology department at University Hospital Plymouth, a 1000-bedded hospital serving a population of 500,000 people. From this group, we identified all individuals referred to the endocrinology department with a suspected diagnosis of adrenal insufficiency. Patients were established on adrenal steroid replacement and subsequently underwent formal pituitary testing. People were included if they had pituitary disease, as evidenced by low ACTH, other pituitary dysfunction and/or abnormalities on pituitary imaging.

Results: Nine hundred and fifty-four patients received ICI therapy during the study period, and 37 (a prevalence of 3.9%) developed hypothalamic-pituitary-adrenal axis dysfunction. Their mean age was 65 years, and 70% were male. About 86.5% of the total patients affected were treated for metastatic malignancies. Ten of the 37 patients died during follow-up as a direct consequence or complication of their primary cancer diagnosis. The median interval for the onset of symptoms was 4 months. Following repeated testing, there was no recovery in cortisol or ACTH levels for any individual. Other permanent anterior pituitary hormone defects were unusual. Hypophysitis associated with immunotherapy appears to specifically target the corticotrophs, with no evidence of recovery over time. There was a specific abnormality seen in MRI scans of 7 of 27 patients who had scans, which appeared to be a particular feature of immune-mediated hypophysitis. These were confined to the anterior aspect of the pituitary gland, appearing as striations, and were not visible on any of the scans performed more than 3 months after the likely onset of the disease.

Conclusion: These data show that immune-related hypophysitis is a common complication of immune checkpoint inhibitor therapy. This may result in an imaging abnormality within the areas of the pituitary that are richest in corticotrophs. The endocrine consequence of this is a permanent defect in ACTH and, therefore, cortisol production.

Background: Bariatric surgery induces significant weight loss, increases insulin sensitivity, and improves dyslipidemia. As one of the most widely performed bariatric surgeries, laparoscopic sleeve gastrectomy (LSG) is thought to improve the metabolic profile along with weight loss. The objective of this study was to evaluate longitudinal changes in the serum metabolite levels after LSG and elucidate the underlying mechanisms of metabolic improvement.

Methods: Clinical metabolic parameters and serum samples were collected preoperatively and at 1, 3, and 6 months postoperatively from nine patients with obesity undergoing LSG. Serum metabolites were measured using a non-targeted metabolic liquid chromatography-mass spectrometry method.

Results: During the 1, 3, and 6 months postoperative follow-up, the body mass index, HOMA-IR, and liver fat content showed a gradual descending trend. A total of 328 serum metabolites were detected, and 38 were differentially expressed. The up-regulated metabolites were mainly enriched in ketone body metabolism, alpha-linolenic acid and linoleic acid metabolism, pantothenate and CoA biosynthesis, glycerolipid metabolism, and fructose and mannose degradation, while the down-regulated metabolites were closely related to caffeine metabolism, oxidation of branched-chain fatty acids, glutamate metabolism, and homocysteine degradation. Notably, nine metabolites (oxoglutarate, 2-ketobutyric acid, succinic acid semialdehyde, phthalic acid, pantetheine, eicosapentaenoate, 3-hydroxybutanoate, oxamic acid, and dihydroxyfumarate) showed persistent differential expression at 1, 3, and 6 months follow-up. Some were found to be significantly associated with weight loss, insulin resistance improvement, and liver fat content reduction.

Conclusions: This finding may provide a new perspective for revealing novel biomarkers and mechanisms of metabolic improvement in obesity and related comorbidities.